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About
Our Story
Facility
Instructors
Core Values
Closures, Hours, and Location
Blog
Swim Lessons
Baby Swim
Learn to Swim
Adult
Welcome Packet
Swim Team
Swim Team
Swim Team Information
Members
Policies and Procedures
Class Absence Request
Makeup Request
Unlimited Swim Request
Progress Evaluation Request
Waitlist Request
Cancellation Request
Contact
Contact Us
Employment Opportunities
Employee Login
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Special Considerations
Special Considerations
Form filled out Date and time
Student's First Name
*
Last Name
*
Name of Person filling out this form
*
Email Address
*
Phone Number
*
Preferred Method of Contact
*
Please Select
Email
Phone
Do you have any special considerations about your child’s lessons you would like to share/discuss with us?
Are there any challenging behaviors we might encounter? If so, what strategies do you use to prevent or mitigate these behaviors?
What reinforcement strategies, if any, do you use with your child?
The goals I have for my child’s lesson are (check all that apply):
Learn to swim independently
Physical activity
Social interaction
Recreation/Entertainment
Other (please specify below)
Other (Please specify your goals for your child's lessons)
What are some of your child's interests (ex. sports, movies, characters, games)?
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