Register

Parent's Name*

First Last

Address*

Street Address City ZIP Code

Email*

Enter Email Confirm Email

Cell Phone: Rain Out notification (must receive text messages)*

What specific person/media referred you to us?

Register Your Children

How many children are you registering?*

Child 1 Name*

First Last

Child 1 Age*

Child 1 Gender*

Male
Female

Can child 1 swim unassisted with their face in the water?*

Yes
No

Has child 1 taken swim lessons before?*

Yes
No

Where has child 1 taken lessons?*

Wrinkled Feet
City Pool / Aquatic Center
Other
ISR classes
Mommy & Me classes

How would you describe CHILD 1's ability as a swimmer? (Select as many as you like)*

Loves the water and can't wait to jump in
Can swim ALL ALONE with face in water
Completely comfortable in water
Needs to improve swimming strokes
Can swim but is nervous in the water
Can swim but an adult needs to be close
I don't feel good about leaving him/her alone in water

How would you describe CHILD 1's main attitude toward learning to swim? (select as many as you like)*

Yay! I'm excited!
Okay. Sounds like a good activity!
I'm nervous, but I'll do it!
I'm terrified!
I haven't told my child yet but I don't think they are going to like it.

Child 2 Name*

First Last

Child 2 Age*

Child 2 Gender*

Male
Female

Can child 2 swim unassisted with their face in the water?*

Yes
No

Has child 2 taken swim lessons before?*

Yes
No

Where has child 2 taken lessons?*

Wrinkled Feet
City Pool / Aquatic Center
Other
ISR classes
Mommy & Me classes

How would you describe CHILD 2's ability as a swimmer? (Select as many as you like)*

Loves the water and can't wait to jump in
Can swim ALL ALONE with face in water
Completely comfortable in water
Needs to improve swimming strokes
Can swim but is nervous in the water
Can swim but an adult needs to be close
I don't feel good about leaving him/her alone in water

How would you describe CHILD 2's main attitude toward learning to swim? (select as many as you like)*

Yay! I'm excited!
Okay. Sounds like a good activity!
I'm nervous, but I'll do it!
I'm terrified!
I haven't told my child yet but I don't think they are going to like it.

Child 3 Name*

First Last

Child 3 Age*

Child 3 Gender*

Male
Female

Can child 3 swim unassisted with their face in the water?*

Yes
No

Has child 3 taken swim lessons before?*

Yes
No

Where has child 3 taken lessons?*

Wrinkled Feet
City Pool / Aquatic Center
Other
ISR classes
Mommy & Me classes

How would you describe CHILD 3's ability as a swimmer? (Select as many as you like)*

Loves the water and can't wait to jump in
Can swim ALL ALONE with face in water
Completely comfortable in water
Needs to improve swimming strokes
Can swim but is nervous in the water
Can swim but an adult needs to be close
I don't feel good about leaving him/her alone in water

How would you describe CHILD 3's main attitude toward learning to swim? (select as many as you like)*

Yay! I'm excited!
Okay. Sounds like a good activity!
I'm nervous, but I'll do it!
I'm terrified!
I haven't told my child yet but I don't think they are going to like it.

Scheduling

Check out current class availability.

Please list 3 choices of the weeks and times you would like. I will contact you if you DO NOT get your first choice:

First Choice*

Second Choice*

Third Choice*

Additional Notes

Please indicate any specific requests needed (ex. I am signing up for two weeks and here are my choices..., I am requesting to be in the class with..., etc.)

Swim Lesson Agreement*

I have agreed to the Swim Lesson Agreement

To make sure you are human, please type what you see in the image.

Please read first!

Register Your Children

Scheduling