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ALBRIGHT AQUATICS PRIVATE SWIM LESSONS REQUEST

 

Student name: first last     Student age:

Parent/Guardian: (if applicable)  first last

Contact email:    Contact Phone:

Swimming ability (beginner, competitive, etc.):

Swimming goals (learn to swim, triathlon training):

Best Available Times (Note: lessons take place only during open pool hours, please see schedule below and check your preferences):

Monday, Wednesday, Friday 6 - 10 a.m.
Tuesday, Thursday 8 - 10 a.m.
Monday through Friday 11:30 a.m. - 1 p.m.
Monday through Thursday 4 - 6 p.m. 
Saturday and Sunday 1 - 4 p.m.

Additional Info (Gender preference for instructor, special needs, etc.):

In order to help prevent abuse of this form, please enter the FOURTH character in the Albright College logo below:

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