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Parent Name
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Parent Email
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Swimmer Name
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Swimmer Age
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Please check off any/all abilities that apply to your swimmer.
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Not yet comfortable in the water – Just starting out!
Comfortable in the water – Haven’t learned proper freestyle just yet
Comfortable in the water – General understanding of proper freestyle and backstroke
Very comfortable in the water – Able to swim all four strokes
Very comfortable in the water – Strong in all four strokes
How often are you looking to do lessons?
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Weekly
Bi-Weekly
Monthly
As Needed
Please describe any specific requests you may have (if your swimmer has any special accommodations / preference for male or female coach, etc)
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