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Home
About
Swim Lessons
Swim Team
- Gold Medal Swim Teams
- Gold Medal Swim Club
Members
Contact
Pre-Registration
Boot Camp

Pre-register Now Boot Camp

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*
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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Name
This field is for validation purposes and should be left unchanged.

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Gold Medal Swim School
6909 West Ray Road #27, Chandler, AZ 85226

(480) 961-7946 (SWIM)

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