Swim Lesson Registration Form

Private/Semi-Private Lessons
Semi-private swim lessons are limited to two (2) participants. All lessons are 30 minutes long. Please complete and submit this form.

Private Swim Lessons are scheduled on a first come, first serve basis. When registration begins for classes, it also begins for Private/Semi-Private Lessons. Interested patrons should complete and submit tis request form. Please be aware that it may take up to two weeks to schedule a lesson, and that registration ends the second week into classes.

Over the phone applicants are not accepted. Private/Semi-Private Lessons are for individuals three years and older. Semi-private swim lessons are limited to two participants. All lessons are 30 minutes long, and they begin and end with the session. If you have any questions please feel free to contact the Swim Lessons Coordinator, Kira Collins at 734-661-8045 or through email at kcollins@annarborymca.org.

Participant Name:: *

Participant Name:

Participant Birthdate:: *

Participant Birthdate:

Gender: *

Gender

Member: *

Member or Non-Member?

Parent Name:

Parent Name (If applicable):

Phone Number: *

Daytime Phone Number:

Street Address: *

Street Address:

City: *

City:

State: *

State:

Zipcode:: *

Zipcode:

Email Address:

Email:

Swim Ability: *

Swim Ability?

Preferred Days: *

Preferred Days for Lessons:

Preferred Times: *

Preferred Times for Lessons:

Number of Lessons: *

Number of Lessons you would like?

Instructor Gender Preference:

Instructor Gender Preference?

Specific Instructor Request:

Request a specific Instructor:

Authorization: *

I Understand.

Lesson availability will be dependant upon pool space and instructor availability. Someone will contact the participant with in two weeks of receiving this registration form. Lessons may be rescheduled no less than 6 hours before the start of the scheduled lesson. Payment is required for missed lessons or cancellations. Cancelled lesson will be rescheduled based on the instructor’s availability and pool space.

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