2024 Swim Lesson Application

Fill out each section carefully before submitting this application.

There are 5 pages to this application form.

Complete Only 1 Application Per Student.

It is highly recommended to use a computer to fill out this application.

PLEASE NOTE, SPACE IF VERY LIMITED AND YOUR DESIRED CLASS TYPE OR SESSION DATE MAY NOT BE AVAILABLE.

CURRENT AVAILABILITY AS OF 05/01/2024:

Session 1: 100% Full *NO SPOTS LEFT*

Session 2: 78% Full

Session 3: 56% Full

Select your child's school: * 🛈

Montessori of WALNUT

Student Information

[Student's] First Name: *

[Student's] Last Name: *

Current Age: [Years + Months] * 🛈

Date of Birth: * +

Classroom #: *

Is child FULLY Potty Trained?: * 🛈

YES

NO

School Schedule Availability

To ensure that your child's swim lessons are both convenient and effective, please indicate the times they are typically DROPPED-OFF and PICKED-UP from school on lesson days. This information allows us to align their swim lesson times with their school schedule, minimizing disruptions to their daily routine.

Additionally, we use this information to match Semi-Private students with compatible partners based on both their school schedule availability and skill levels. By considering these factors together, we can create balanced and productive learning environments for all participants.

SCHOOL "DROP OFF" TIME
What time does your child get dropped off on Wednesdays & Fridays? * 🛈

SCHOOL "PICK UP" TIME
What time does your child get picked up on Wednesdays & Fridays? * 🛈

STOP

Based on your previous answer, your child is not eligible to participate in our Swim Program at the Montessori of Walnut at this time.

Per the Montessori of Walnut's school policy, children must be 3 years old AND fully potty trained for a minimum of 3 months in order to register for this swim program.

Thank you for your understanding.

Has your child had ANY previous "Swim Lesson" experience? *

YES

NO

Please Select All That Apply: *

Completed Preschool Aquatics LEVEL 1

Completed Preschool Aquatics LEVEL 2

Completed Preschool Aquatics LEVEL 3

Completed Parent & Child LEVEL 1 and/or 2

Completed OTHER types of organized swim lessons (please specify below) Completed OTHER types of organized swim lessons (please specify below)

[Please Select ALL That Apply]
My child . . . . . . . . * 🛈

Is FEARFUL of Pools/Water

Is COMFORTABLE in Pools/Water

Can FULLY SUBMERGE entire head/face under water (comfortably)

Has NEVER been in a swimming pool

Has had LOTS of swimming pool experience

Other (please specify) Other (please specify)

Please specify your child's fear of water.
If your child has had any traumatic pool/swim/water experience and is absolutely terrified, we recommend putting them in "Parent and Child" swim classes until they are more comfortable before participating in our "Preschool Aquatics" lessons with our Montessori of Walnut school program as parents are not permitted to particiate in this private program. *

Parent/Guardian Information

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Phone Number: *

Alternate Phone Number (optional):

Email Address: *

Re-Enter Email Address *

Alternate Email Address (optional):

TODAYS DATE: * +