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Pre-Registration Survey
winter 2024
January 8th-March 31st
The swimmer(s) took lessons during this fall season (Sep-Dec)

billing information

swimmer(s)' information

Le nageur a-t-il été hospitalisé au cours des 12 derniers mois? / Has the swimmer been hospitalized in the last 12 months?
Le nageur souffre-t-il d'un problème de santé, d'une maladie, d'une allergie ou d'une blessure? / Is the swimmer suffering from a medical condition, illness, allergy, or injury?
What are the swimmer's goals?
Le nageur a-t-il été hospitalisé au cours des 12 derniers mois? / Has the swimmer been hospitalized in the last 12 months?
Le nageur souffre-t-il d'un problème de santé, d'une maladie, d'une allergie ou d'une blessure? / Is the swimmer suffering from a medical condition, illness, allergy, or injury?
What are the swimmer's goals?
Le nageur a-t-il été hospitalisé au cours des 12 derniers mois? / Has the swimmer been hospitalized in the last 12 months?
Le nageur souffre-t-il d'un problème de santé, d'une maladie, d'une allergie ou d'une blessure? / Is the swimmer suffering from a medical condition, illness, allergy, or injury?
What are the swimmer's goals?
Le nageur a-t-il été hospitalisé au cours des 12 derniers mois? / Has the swimmer been hospitalized in the last 12 months?
Le nageur souffre-t-il d'un problème de santé, d'une maladie, d'une allergie ou d'une blessure? / Is the swimmer suffering from a medical condition, illness, allergy, or injury?
What are the swimmer's goals?
Le nageur a-t-il été hospitalisé au cours des 12 derniers mois? / Has the swimmer been hospitalized in the last 12 months?
Le nageur souffre-t-il d'un problème de santé, d'une maladie, d'une allergie ou d'une blessure? / Is the swimmer suffering from a medical condition, illness, allergy, or injury?
What are the swimmer's goals?

registration details

Register for Private Instruction
Register for Semi-Private Instruction

Lesson Location: Where would the lessons take place?

availability

Please select all availabilities that apply

The more options provided, the better the chances of securing a slot!!

Vacation Schedule (optional)

Please indicate the weeks you would like to skip, if you already know them 

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