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Wildlife Water School, LLC

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Lesson Sign-Up form

Wilmerding

First Name

Email

Last Name

Phone

Relationship to the swimmer (s)

Swimmer (s) name(s) and age (s)

What is your availability? Please pick multiple * Required

Sundays 4-5 pm

Sundays 5-6pm

Sundays 6-7pm

Sundays 7-8pm

Wednesdays 8-9am

Wednesdays 9-10am

Wednesdays 10-11am

Do you have flexibility in your schedule to move possible lessons times ? Yes/No

What type of lessons are you intereted in? What session? * Required

Private Lessons

Double Lessons

Mommy/Daddy and Me Lessons

Group Lessons

Sibling Group Lesson

Toddler Class

Stroke Improvement Class

I am open to Greensburg too!

Please specify if you have multiple children that need different lessons

Please describe your swimmers' swimming ability

Does the swimmer(s) have any disabilties? Please describe in detail

Any comments/questions/concerns?

Any allergies/health conditions to ensure the safety of everyone?

How would you like us to approach crying during a lesson?

Does the swimmer(s) have any specific fears of the water? Please explain

What teaching methods work best?

Would you be willing to sign a liability contract?

Length of lesson?

Specific Instructor Request? You can choose multiple!

Miss Vicky

Miss Ads

Miss Lydia

Miss Kayla

Miss Adi

Miss Adeline

Anyone

Miss Marlee

Miss Savanna

What animal levels' page is the swimmer (s)? Please refer to levels to estimate. This must be answered for each swimmer.

We will get back to you about openings!

Wildlife Water School

Wildlifewaterschool@gmail.com

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