Schedule a Swim Consultation

Parent or Guardian
Name*
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Contact Me by*
- Email
- Phone
Email*
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Phone (optional)
Phone*
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Address*
Street Address Address Line 2 City State ZIP Code
Swimmer's Information
Name*
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Age*
Swimming Experience*
- some fear of water
- child (ages 3 and older) or adult seeking to become comfortable in the water; gain confidence; and learn to move in water.
- individual is comfortable in the water, can submerge their face and head, but has had no swimming lessons. Children must be: mature 5 or older; able to take direction; be independent of their parents; and able to stand in 4.5 feet of water.
- swimmer has good freestyle and backstroke; wants to learn breast and fly strokes, and starts and turns.
- swimmer is proficient in all four competitive strokes and starts and turns; is on a swim team; and needs technique refinements.
Competitive Experience
Years Competing & Swim Teams*
Please enter the number of years the swimmer has been competing along with the names of their swim teams
Freestyle Time - 50 meters
Freestyle Time - 100 meters
Most Competitive Events & Times
Please enter the swimmer's most competitive events and times.

Parent or Guardian