October Swim Clinic Registration
Saturday, February 23rd 2019
Kaneohe District Swiming Pool
(45-660 Keaahala Rd, Kaneohe, HI 96744)

8:00am Volunteer/Coaches Orientation
8:30am - 9:15am Beginner Session
9:45am - 10:30am Intermediate Session
10:45am - 11:30am Advanced Session

Participant's Full Name *
Your answer
Age *
Your answer
Email *
Your answer
Phone Number *
Your answer
Diagnosis *
Comfort Level In The Water *
Not Very Comfortable
Very Comfortable
Swim Time *
Previous experience in the water? *
Your answer
Have you attended an AccesSurf Swim clinic before? *
If you have attended an AccesSurf swim clinic previously what did you work on last time?
Your answer
What would you like to work on this time? *
Your answer
Ultimate swimming goals? *
Your answer
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