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Wildlife Water School, LLC
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Lesson Sign-Up form
Questionnaire
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
Sundays 1-2pm
Sundays 2-3pm
Sundays 3-4pm
Sundays 4-5 pm
Sundays 5-6pm
Sundays 6-7pm
Weekday evenings
Do you have flexibility in your schedule to move possible lessons times ? Yes/No
Choose an option
What type of lessons are you intereted in?
Private Lessons
Double Lessons
Mommy/Daddy and Me Lessons
Group Lessons
Sibling Group Lesson
Toddler Class
Please specify if you have multiple children that need different lessons
Please describe your swimmers' swimming ability
Does the swimmer(s) have any disabilties?
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?
Choose an option
Length of lesson?
Choose an option
Specific Instructor Request? You can choose multiple!
Miss Vicky
Miss Ads
Miss Lydia
Miss Serena
Miss Evi
Miss Berna
Miss Adi
Miss Maura
Anyone
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!
Submit
Thanks for Submitting!
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