Private Swim Lesson Interest
Private Lesson Inquiry Form
Please provide the information below so we may connect you with one of our certified swim instructors. We will contact you as soon as availability opens! Thank you for your interest in YMCA swim lessons.

1. Due to the high demand for private instruction, we cannot guarantee you an instructor.
2. You must purchase a minimum of 4 lessons and make payment before your first lesson.
3. All students must be members of the Greater Bergen County YMCA

Parent or Guardian's Name
Your answer
Phone Number
Your answer
E-mail and Phone number
Your answer
Name of Swimmer
Your answer
Age of Swimmer
Your answer
(optional) Name of 2nd Swimmer
Your answer
(optional) Age of 2nd Swimmer
Your answer
Tell us your availability (check all that apply)
(morning) 9:00 AM - 12:00 PM Adults only
(afternoon) 12:00 PM - 3:00 PM Adults only
(after school) 3:00 PM - 6:00 PM
(evening) 4:00 PM - 7:00 PM
(late night) 7:00 PM - 10:00 PM M-F
Does the swimmer have an intellectual or physical disability?
Thank you for choosing the YMCA of Greater Bergen County!
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