SPLASH Academy Private Swim Lesson Requests- Fall 2025
Please complete this form to request Private & Semi-Private Lessons for the Fall 2025 Season (September- December)

After you complete your request, the Aquatics Department will reach out for scheduling.
Please await response from the Aquatics Department, no further email required.

Membership is required for participants to be eligible for Private & Semi-Private Lessons. Please contact our Member Services department for details on Membership types and pricing. (908) 359-3600

MEMBERSHIP IS REQUIRED TO ACCESS PRIVATE OR SEMI PRIVATE LESSONS. PLEASE AWAIT RESPONSE FROM THE AQUATICS DEPARTMENT AND CONFIRM YOUR FIRST SESSION PRIOR TO ATTAINING MEMBERSHIP.
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Email *
What type of swim lessons are you looking for? *
NOTE: Semi-Private Lesson requests will only be considered for children of the same age and skill level.
Parent/Guardian (Main Contact) Name *
Swimmer Name - #1 *
Swimmer Age - #1 *
Swimmer Name - #2 (Semi-Private Only)
Swimmer Age - #2 (Semi-Private Only)
Telephone Number *
(### - ### - ####)
Email Address *
Please complete the section below regarding your scheduling needs.
First Preference - What day works best for your schedule?
Clear selection
First Preference - What times are you available?
Clear selection
Second Preference - Day
Clear selection
Second Preference - Time
Clear selection
When would you like to start lessons?
MM
/
DD
/
YYYY
Is the swimmer currently a Pinnacle Health & Fitness Member? *
NOTE: Membership is required for Private & Semi-Private Lessons.
Do You Have Any Special Requests?
If you prefer male/female/specific instructor, Please list here.
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