Adult Lessons: Pre-class Questionnaire
Please fill out this preliminary form so we may better understand your needs and target your specific goals.
Name (first and last)
What is the best number to reach you?
Which Location do you prefer?
Upper West Side Flagship Pool . (Monday - Friday, mornings and evenings)
Tribeca Flagship Pool (Tuesday - Friday evenings, Mondays & Friday mornings)
Crown Heights Location (Tuesday evenings only)
What day works best for you?
What time works best for you?
7:15am (Tribeca only, Monday & Friday)
7:55am (Upper West Side, Monday - Friday)
8:00am (Tribeca only, Mondays & Fridays)
6:30pm (Crown Heights only, Tuesdays only)
6:45pm (Crown Heights & UWS only)
7:00pm (Tribeca & UWS only)
7:45pm (Tribeca only, Tuesday - Friday)
1. Are you comfortable putting your face in the water?
If YES, please continue to question 2. If NO, please skip to question 6.
2. Are you able to float on your back without assistance?
If YES, please continue to question 3. If NO, please skip to question 6.
3. Are you able to tread water (keep your head above the surface) in depths where you can't stand?
If YES, please continue to question 4. If NO, please skip to question 6.
4. Without a floatation device, can you swim a short distance without stopping or needing help?
Yes, but with some difficulty
Not really, but willing to try
No, and the thought frightens me.
5. Are you comfortable swimming the basics of any these strokes? Please click all that apply:
6. Please rank your swimming ability from 1 to 5:
Fearful: cannot swim
Knowing all 4 strokes
7. Do you tend to do better with a personality that pushes and challenges you, or one that is more cosseted and supportive?
8. What are your swimming goals?
Overcome fear of the water
To be more comfortable in the water and swim better
Swim for exercise or physical therapy
Become a better swimmer with stamina and/or stroke refinement
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of Imagine Swimming.