UCCS Private Swim Lesson Registration
The UCCS Campus Recreation Aquatics Program offers a wide selection of lessons to UCCS community, children and non-members. All instructors are UCCS students, certified by nationally recognized organizations to teach the fundamentals of water safety, stroke development and skill refinement. Swim lessons are either 30 or 45 minutes in length.

Please visit us at http://www.uccs.edu/recwellness/campus-rec/aquatics/swim-lessons.html for current selections, fee structures and more information about swim lessons.

If registering for a semi-private lesson, please fill out another form for the other participant and include their name on this form.
**** ATTENTION- We currently have a wait-list for our private swim lessons, due to our high demand of lessons and limited instructors. Thank you for your patience as we work through our wait-list. ****
Email address *
Your answer
Today's date *
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Name of swim lesson participant *
Your answer
Please include the name of the other student(s) if this is a semi-private lesson
Your answer
Age of participant (children must be at least 5 years old to be eligible for swim lessons) *
Your answer
Birth date of participant *
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DD
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Name of parent or guardian (if child is under 18)
Your answer
Full address *
Your answer
Home phone
Your answer
Cell phone *
Your answer
List the participants availability (days of week AND times) *
Your answer
If the participant has previously taken lessons, summarize their current skill level *
Your answer
What are some goals you would like to accomplish with these lessons? *
Your answer
Please select desired swim lesson package (for updated prices, please see our website) *
Preferred Payment Type *
When would you like to start lessons?
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DD
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YYYY
Thank you for choosing UCCS!
**** ATTENTION- We currently have a wait-list for our private swim lessons, due to our high demand of lessons and limited instructors. Thank you for your patience as we work through our wait-list. ****

Once you have successfully submitted your form, please allow 2 business days for our reply and confirmation of your request.

No refunds will be issued. Swim lesson packages expire after 6 months of purchase.

For additional information or questions, contact:
Avery W
Swim Instructor Program Assistant
Office 719.255.5213
E-mail aquatics@uccs.edu
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