Group Swim Lessons | Osher Marin Jewish Community Center

Group Swim Lessons

Thank you for your interest in signing up for Group 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
 
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