Ultimate Swimmer Swim Lessons 
Individual & Group Lessons Servicing Edmond, OK Swimmers
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Swimmer Name *
Age *
Gender *
What is your child's previous experience with swimming lessons or water activities?
Does your child have any fears or concerns related to swimming or being in the water?
Are there any medical conditions or physical limitations we should be aware of?
How comfortable is your child in water of varying depths?
Does your child have any specific goals or areas they would like to focus on during lessons?
Are there any techniques or strokes your child is particularly interested in learning or improving?
How does your child typically respond to instruction and correction during activities?
Does your child have any sensory sensitivities or preferences that we should consider?
Are there any behavioral considerations or strategies that work well for your child in a learning environment?
How would you like to receive updates and feedback on your child's progress?
Do you prefer group or individual. 
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Parent/Guardian Full Name *
Email *
Phone Number *
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