Swim School

Summer 2019 One on Ones
Swimmers MUST be Registered for other Summer Activity

Magenta fields are required.

Current Family Past Family New Family

Location: Apple Valley
 
 
Parents’ Names:
E-mail address:
Address:
City:
State:
Zip:
Phone:
Alt Phone:
How did you hear about us?
 
 
1st Swimmer’s Name:
Birthday: ,
Level:
What else Registered For?
 
  
2nd Swimmer’s Name:
Birthday: ,
Level:
What else Registered For?
 
 
3rd Swimmer’s Name:
Birthday: ,
Level:
What else Registered For?
 
  
     Date/Time 1    Date/Time 2    Date/Time 3    Date/Time 4
Swimmer 1
Swimmer 2
Swimmer 3

Times: ½ hour lesson between 1:00pm–3:30pm. Please choose your start time.

Monday–Thursday ONLY
7/15–7/18
7/29–8/1
8/12–8/15* Levels JD3–RD can choose to swim at Bluewater Aquatic Center for practice in a longer, colder, deeper pool
8/26–8/28 (Monday–Wednesday ONLY)

 
  
Tuition Information
One-on-ones $18 per 30 minute private lesson
 
Tuition: $
 
 
Special Instructions/Comments:
 
Release
In consideration for Wise Swim School accepting my child into its program, I agree to assume all risks, costs and loses sustained by my child, myself and our guests in connection with the use of the Wise Swim School facility. I give permission to Wise Swim School and/or appropriate medical personnel to perform, at my expense, any emergency procedures judged necessary for the care and protection of my child while under the supervision of Wise Swim School. *We reserve the right to cancel/combine classes. Teacher requests can me made but are not guaranteed.

Please type an “x” in the box to indicate your agreement.

 
 
 
Enter the letters and/or
numbers in the image above:
  Try a new image
 
 
Bluewater Acquatic CenterRiptide Swim Team