Customer Inquiry Form Fast Track Swimming

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Please fill in the following info, and we will schedule a class that fits your child and your needs!

Parent's name *

Email Address *

Children's name and Date of Birth *

Phone Number *

To facilitate our schedule and yours, please select what time frames work best for you. Add days in other if needed more specific. (Please note 5-6 is the most requested and unfortunately, as much as we wish we could, we can't have everyone at that time. But we try as hard as we can to get the best schedule for you). *

Morning 9-12 pm

Afternoon 2-5 pm

Evening 5-8 pm

Saturdays 9-12 pm

Other:

Required

Are there any needs, concerns with your child. IE requests a certain coach, special needs your child has?

Please fill out per child: Child 1 (oldest child) *

My child is afraid of the water without a flotation device

My child can go in the water with no flotation device, no fear but has no skills

My child can hold their breath in the water for 5 seconds with no floatation device

My child can glide under water to me without anyone holding or floatation device for 5 feet

My child can float on their back for 5 seconds with no help

My child can roll and float unassisted

My child has been in a swim school but can not do any of the above

My child can do all of the above and ready to learn strokes

my child needs technique work and knows how to use freestyle and backstroke arms

Other:

Required

Please fill out per child: Child 2

My child is afraid of the water without a flotation device

My child can go in the water with no flotation device, no fear but has no skills

My child can hold their breath in the water for 5 seconds with no floatation device

My child can glide under water to me without anyone holding or floatation device for 5 feet

My child can float on their back for 5 seconds with no help

My child can roll and float unassisted

My child has been in a swim school but can not do any of the above

My child can do all of the above and ready to learn strokes

my child needs technique work and knows how to use freestyle and backstroke arms

Please fill out per child: Child 3

My child is afraid of the water without a flotation device

My child can go in the water with no flotation device, no fear but has no skills

My child can hold their breath in the water for 5 seconds with no floatation device

My child can glide under water to me without anyone holding or floatation device for 5 feet

My child can float on their back for 5 seconds with no help

My child can roll and float unassisted

My child has been in a swim school but can not do any of the above

My child can do all of the above and ready to learn strokes

my child needs technique work and knows how to use freestyle and backstroke arms

Please fill out per child: Child 4

My child is afraid of the water without a flotation device

My child can go in the water with no flotation device, no fear but has no skills

My child can hold their breath in the water for 5 seconds with no floatation device

My child can glide under water to me without anyone holding or floatation device for 5 feet

My child can float on their back for 5 seconds with no help

My child can roll and float unassisted

My child has been in a swim school but can not do any of the above

My child can do all of the above and ready to learn strokes

my child needs technique work and knows how to use freestyle and backstroke arms

Does your child(red) have any special needs or anything you'd like us to be aware of

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