Private Lesson Request

Private Lesson Booking Information

Form filled out Date and time
Thank you for considering private lessons with the Gold Medal Swim School where our goal is simple, “We do What is Best for Kids”.
Please read thoroughly the following information and share insight as to your child's needs so we may better serve your family.

Private lessons registration request are accepted using this form. Please indicate your schedule preferences and a staff member will call to finalize scheduling within the next 48 hours. The fee for private lessons is $360.00 per month (4 classes on average each month).

Special situation, private lessons are offered at a discounted rate for students who are unable to participate in a group class. Discounted private lessons are limited in number and work from the waitlist. If you would like to discuss this option, please complete the form below. The fee for discounted private lessons due to a special situation is $180.00 per month (4 classes on average each month).

Private and Special Situation Private lessons are not eligible for the Unlimited Swim program or Instructor in Training classes. Class absences, makeup lessons, and cancellations for private lessons follow the same policies and procedures as all the other programs offered at Gold Medal. If you are new to Gold Medal, your acknowledgement of these policies and procedures is necessary for registration.

*Gold Medal places a priority on instructor consistency for our swimmers however, private lesson classes will have a substitute teacher from time to time. Makeup sessions and/or refunds are not offered due to a teacher absence.
Student's First Name*
Last Name*
Name of Person filling out this form*
Email Address*
Phone Number*
Preferred Method of Contact*
What type of private lesson are you requesting?
Please read above regarding the types of available private lessons and select your preference below.
Do you have any special considerations about your child’s lessons you would like to share/discuss with us?
Would you like to provide any helpful strategies to prevent or mitigate behaviors that may interfere with your swimmer's lesson?
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)?
Schedule Preferences
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