Child Private Swim Lessons Form Child Private Swim Lessons Form Please use the form below to register for the child private swim lessons. Child must be 3 years of age or older and out of diapers. **Please Note: Non-members with swim lessons are only allowed use of the pool during their scheduled lessons. Swimming before and after a lesson and Use of the facility by a child or family members is prohibited. The Falls area is off limits to minors at all times, excluding family hours for Dedman Center Members only. Before completing this form, please review the Swim Lesson Rules and Fees. How many swim lessons would you like to purchase? * Single lesson 5-Pack 10-Pack I confirm that I have read and understand the SMU Campus Recreation Aquatics Swim Lesson Terms and Conditions available on the SMU Aquatics Swim Lesson webpage and I further agree to the Cancellation policy of 48 hours advance notice. I agree that failure to notify my instructor of cancellation in less than 48 hours will result in the loss of a lesson without refund or reimbursement. I also understand that swim lessons are non-refundable and non-transferrable to anyone other than the person listed. * I Agree and Accept Parent First Name * Parent Last Name * Parent Date of Birth * Home Phone * Alternate Phone * Email * Preferred Method of Contact * Home Phone Alternate Phone Email Instructor Preference * Female Male No preference If known, please provide name of preferred instructor. Child First Name * Child Last Name * Child Age * Child Date of Birth * What best describes the child's current swim level? * Cannot Swim Beginner Intermediate Advanced Please Rate Child's Comfort Level in Water * Fear of Water Somewhat Comfortable Comfortable Very Comfortable What are the desired outcomes or goals for these lessons? Do you have any concerns that you would like noted about this child? Weekend Availability to Schedule Lessons (Check All That Apply)? Saturday Afternoons Sunday Afternoons Sunday Nights Weekday Availability (Check All That Apply)? Monday Mornings Monday Afternoons Monday Evenings Tuesday Mornings Tuesday Afternoons Tuesday Evenings Wednesday Mornings Wednesday Afternoons Wednesday Evenings Thursday Mornings Thursday Afternoons Thursday Evenings Friday Mornings Friday Afternoons Friday Evenings How did you hear about the SMU Campus Recreation Aquatics swim lessons? Will there be an Adult Caretaker, other than parent, accompanying child to lessons? * Yes No If so, please provide Adult Caretaker First and Last Name Adult Caretaker Phone: Adult Caretaker Relationship to Child reCAPTCHA If you are human, leave this field blank. Submit Δ
