Registration If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required First Name * Last Name * Email * Phone * Pool Address * City * Zip / Post Code * Your Pool Type * Home Pool Housing Community Pool Hotel Pool Member Only Pool Other Pool Number of Lessons * 6 Lessons 12 Lessons 18 Lessons Length of Lessons * 30 Minutes 45 Minutes 60 Minutes 90 Minutes 120 Minutes Number of Students 1 2 3 4 Student's Name * Student's Age * 12-18 months 18-24 months 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18-30 31-60 61+ If registering more than one student - please include their names & ages here: Swimming Ability * Complete Beginner Complete Beginner Fearful of Water Beginner Prior Lessons Intermediate Advanced Questions or things we should know about the student? (Special needs, medical issues, goals) Desired Start Date Desired Lessons Per Week * 1 Lesson2 Lessons3 Lessons4 Lessons5 Lessons6 Lessons7 Lessons Days Available (check as many as possible) * MondayTuesdayWednesdayThursdayFridaySaturdaySunday Times of Day Available (check all that apply) * Early Morning 6-8amMorning 8am-12pmAfternoon 12-3pmLate Afternoon 3-6pmEvening 6-8pm Special Scheduling Requests * I have read and agree to the Liability Release, Assumption of Risk and Policies. Click Here To Read The Swim Lessons Agreement is an electronic contract that governs your use of and access to the Wiki Wiki Swim School LLC website and services. Upon agreeing to the Swim Lessons Agreement when completing the swim lessons registration form, you acknowledge that you understand and agree to be legally bound by the Swim Lessons Agreement and the terms, conditions and notices contained or referenced herein. Typing your name below creates an electronic signature that has the same legal force and effect as a handwritten signature. Electronic Signature *
