Select Class Type: Individual (1)Sibling (2)Semi-Private (2 not related)Make Your Own Group (3 or more)
Select a Package: 5 lessons10 lessons15 lessons
Payment Options: House ChargeOther
Parent's Name: Phone:
Email: Club Id:
Participant 1's Name: Participant 1's Age:
Participant 2's Name: Participant 2's Age:
Participant 3's Name: Participant 3's Age:
Participant 4's Name: Participant 4's Age:
Child Swim Level: OysterTurtleOtterPlatypusPiranha
Adult Swim Level: BeginnerIntermediateAdvancedTri Training
Days & Times Available for Instruction:
Desired Start Date: YYYY-MM-DD
Have you taken swim instruction at HTSW before? yesno
Do you have an instructor preference?
Please review our Private Swim Lesson Policies & provide your signature and date below:
I have read and agree to abide by the above polices as they apply to Swim Instruction.
Signature: Date: YYYY-MM-DD
Thank you for using HealthTrack Sports Wellness for your swim instruction needs. Please allow 48 hours for a follow up call by a HTSW Aquatic Staff Member to begin selecting mutually agreeable session dates. Question, please contact Jami Omachel, Aquatics Director at 630-942-9600 (x570).