Required fields are marked with asterisks (*)

Private Lesson Request Form

*Please note that Private lessons are dependent on pool space, instructor space and schedules* Please allow up to 2 weeks for processing of each submission.

Parents full name

Patrons full name (who is swimming?)

Age of swimmer

Phone number

Email address

Describe in detail what they would like to work on during the lesson and their current swim experience

How many lessons are they requesting in total?

Date Preference: (a day of the week)

Time Preference: (timeslot you would possibly like to book)

Instructor Preference: (do you have a specific instructor you would rather swim with?)

Can you book with more than one instructor?

Additional Comments

Date of Inquiry