Catalina Swim Lessons sign-up
Sign up for swim lessons. Your child must be 4 years old to participate in swim lessons. We will not allow more than 60 kids in lessons due to group sizes. After 60 swimmers have signed up for lessons, a waiting list will begin forming. After filling out this form, you will receive an email, with confirmation of your submission, and another from Jason Kubick in the next 2-3 of days, confirming he has received it, along with how to pay. If you have any questions about lessons, please email Jason Kubick NOT the pool. Thank you for your interesting in swim lessons!
Email address
Which session(s) are you signing up your swimmer?
Parent(s) Name
Your answer
Phone #
Your answer
Alternate Phone #
Your answer
Alternate Email
Your answer
Name of Child #1
Your answer
Age of Child #1
Your answer
Ability of Child #1 (Please mark the highest level of swimming ability for your child. If you are unsure, please place the child one level down and we will quickly move them up if the swimmer is capable. ***Children who haven't been swimming over the winter will have regressed in ability.)
Name of Child #2
Your answer
Age of Child #2
Your answer
Ability of Child #2 (Please mark the highest level of swimming ability for your child. If you are unsure, please place the child one level down and we will quickly move them up if the swimmer is capable. ***Children who haven't been swimming over the winter will have regressed in ability.)
Name of Child #3
Your answer
Age of Child #3
Your answer
Ability of Child #3 (Please mark the highest level of swimming ability for your child. If you are unsure, please place the child one level down and we will quickly move them up if the swimmer is capable. ***Children who haven't been swimming over the winter will have regressed in ability.)
Name of Child #4
Your answer
Age of Child #4
Your answer
Ability of Child #4 (Please mark the highest level of swimming ability for your child. If you are unsure, please place the child one level down and we will quickly move them up if the swimmer is capable. ***Children who haven't been swimming over the winter will have regressed in ability.)
Emergency contact during swim lessons
Your answer
Emergency contact phone #
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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