Please fill out each section carefully before submitting this form.
There are 4 pages to this form so make sure you complete all of them!
 
[Please Complete 1 Form Per Student]
 
 
Select the school your child is enrolled at: * 🛈

Student Information

 +
Is student Potty Trained?: * 🛈
STOP
Based on your previous answer, your child is not eligible to participate in our Swim Programs at this time. Children must be 2 1/2 years old AND fully potty trained for a minimum of 3 months or longer in order to register for our swim programs.
 
Thank you
Has student had previous "Swim Lesson" experience? *
Please Select All That Apply: *
 
Please Select All That Apply: *
 

Parent/Guardian Information

Powered byFormsite