Swim Enrollment Form - Phoenix Valley
After you fill out this order enrollment form, we will contact you to go over details and availability before your lessons are booked and payment is taken. If you would like faster service and direct information please contact us at (480) 994-5437 or sofun@kidtastics.com
Email address *
Are you a new or existing customer? *
Coupon code?
Your answer
How did you hear about Kidtastics?
Your answer
Child's First & Last Name *
Your answer
Child's Sex *
Child's Age *
What is your child’s experience in the water? *
Your answer
Allergies?
Your answer
Other medical concerns?
Your answer
Child's Special Interest/ Favorite Things (ex. toys, sports, shows, books, games, music) This allows use to get to know your child better to form trust. *
Your answer
Child's Fears/ Dislikes *
Your answer
Do you have any behavioral strategies or positive reinforcers that you would like to share? *
Your answer
What goals do you have for your child’s swim lesson? *
Your answer
Communication information for Children with autism (click all that apply)
Any things else we should know about your child?
Your answer
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