Private And Semi-Private Swim Lessons | Osher Marin Jewish Community Center

Private and Semi-Private Swim Lessons

Thank you for your interest in signing up for Private and Semi-Private Swim Lessons. Please fill out this form, and we will get back to you as soon as possible.

Are you interested in Private, Semi-Private or Group Swim Lessons?
 
* First and Last Name of Swimmer
DOB of First Swimmer (XX/XX/XXXX)
 
First and Last Name of Second Swimmer (if requesting semi-private lessons for 2 swimmers)
DOB of Second Swimmer (XX/XX/XXXX)
 
First and Last Name of Third Swimmer (if requesting semi-private lessons for 3 swimmers)
DOB of Third Swimmer (XX/XX/XXXX)
 
 
Parent's Name - if swimmer is under 18
DOB of Parent (XX/XX/XXXX)
 
* Email Address
 
* Phone Number
 
* Address 1
Address 2
City
* Zip Code
 
Alternate Phone Number
 
* Preferred Start Date
 
* Total Number of Lessons - Please enter a value between 1 and 100.
 
Do you have a preferred instructor? If so, please specify here:
 
* Goals (what do you want to achieve in your lessons?)
Notes or Comments
 
* What days and times are you available for lessons? Each lesson is 30/20 minutes long
 
* Name of person filling out this form