Learn to Swim Sign Up

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Once you have completed this form we will send you an text with the day and time we have available based on your child's skill level as soon as we are able. Due to high demands this could be up to 7 days.

Email *

Parents Name *

Parents Contact Number *

Swimmers Name *

Swimmers Birthday *

YYYY

To try and assess your child’s level of ability please tell us the following. *

Not Comfortable

Somewhat Comfortable

Comfortable

Very Comfortable

Is your child comfortable in the water?

Is your child comfortable with putting their face in the water?

Is your child comfortable with floating on their back?

Is your child comfortable with Freestyle?

Is your child comfortable with Backstroke?

Is your child comfortable with Breaststroke?

Is your child comfortable with Butterfly?

How Did You Hear About Us? *

If there is any additional information you would like us to know about your child, please feel free to use the space bellow.

Send me a copy of my responses.

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