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Primary Contact

Parent Guardian

Relationship *

First Name *

Last Name *

Street Address *

City *

State *

Zip *

Best time to call:

E-mail *

Additional/Emergency Contact

Parent Guardian

Relationship

First Name

Last Name

Street Address

City

State

Zip

Best time to call:

E-mail

Who does Swimmerman contact for scheduling and billing?
*

Swimmer Information

Adult Child

First Name *

Last Name *

Middle

Date of Birth *

Age: *

Lesson Preference

Are there any special concerns/issues Swimmerman needs to be aware of (i.e. special needs, allergies, preferred swim partner, past experiences, etc.)?

If yes, please tell us more!

Click HERE to add another swimmer

Swimmer 2

Adult Child

First Name

Last Name

Middle

Date of Birth

Age:

Lesson Preference

Are there any special concerns/issues Swimmerman needs to be aware of (i.e. special needs, allergies, preferred swim partner, past experiences, etc.)?

If yes, please tell us more!

click here to add another swimmer

Swimmer 3

Adult Child

First Name

Last Name

Middle

Date of Birth

Age:

Lesson Preference

Are there any special concerns/issues Swimmerman needs to be aware of (i.e. special needs, allergies, preferred swim partner, past experiences, etc.)?

If yes, please tell us more!

click here to add another swimmer

Swimmer 4

Adult Child

First Name

Last Name

Middle

Date of Birth

Age:

Lesson Preference

Are there any special concerns/issues Swimmerman needs to be aware of (i.e. special needs, allergies, preferred swim partner, past experiences, etc.)?

If yes, please tell us more!

click here to add another swimmer

Swimmer 5

Adult Child

First Name

Last Name

Middle

Date of Birth

Age:

Lesson Preference

Are there any special concerns/issues Swimmerman needs to be aware of (i.e. special needs, allergies, preferred swim partner, past experiences, etc.)?

If yes, please tell us more!

Availability *

Please give us a general picture of what days and times you would prefer to schedule lessons

How did you hear about us?
*

If referred by a friend, what's their name?
We credit them with SwimmerBucks. This is our way of saying
"Thanks for referring your family and friends"

Payment & Procedures*
Please check each box to verify that you've read and agree with each item

Payment

Full payment is required in advance to secure specific lesson(s) date and time. Payment can be made by credit card, check, or cash.

Non-Refundable Deposit

A non-refunadble deposit is included in the total cost of each lesson.

Make-Up

Swimmerman Swim School does not offer make-up classes for illness or conflicts.

Registration Fee

Every family account is responsible for a $25 Annual Registration Fee to cover the cost of Insurance and Registration for the year.

Private Lessons

Cancellation of a private lesson for any reason within 72 hours of the swim will result in the loss of your non-refundable deposit.

Semi-Private Lessons

If one student cancels, the forfeit their portion of the total cost.
If both parties must cancel, they are each responsible their Non-Refundable Deposit will be deducted from each swimmer's account.

Cancellations & Rescheduling

At least 72 hours advanced notice is required in order to make any adjustments to a scheduled lesson's date and/or time.

Seating for Parents & Spectators

Parents, siblings, and other spectators must remain on the upper deck or porch until asked to come down at the end of the lesson.

Photography

Video and Flash Photography are only permitted during the last 5 minutes of class. Please obtain the instructors prior permission.

I have read and agree with Swimmerman Swim School's payment procedures

Full Name
*

Register Online * Required Fields

Primary Contact

Additional/Emergency Contact

Swimmer Information

Swimmer 2

Swimmer 3

Swimmer 4

Swimmer 5

Availability *

Payment & Procedures* Please check each box to verify that you've read and agree with each item

Register Online
* Required Fields

Payment & Procedures*
Please check each box to verify that you've read and agree with each item