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Existing Students
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Swim Lesson Registration & Waiver
Before securing your lesson session, please complete the registration and waiver form below. Payment is due with registration.
Note: Payment due with Registration- Please do not complete until ready to pay.
Select Your Lesson
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Private - One on On Instruction
Semi Private - Small Group
Mommy & Me
Adult Lesson
Water Aerobics
Parent / Guardian Information
Parent / Guardian Name
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Email
*
Phone
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Swimmer Information
Swimmer Name
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Swimmer Age
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Has Swimmer had lessons before?
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Provide any Additional information you wish for the instructor
Swimmer Support & Instructional Notes
Calhoun Swim is committed to providing a safe, supportive, and inclusive learning environment. The following questions help instructors better support your swimmer. Information is kept confidential and shared only with instructional staff
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My child does not require any additional support at this time.
My child may benefit from additional support. Please share anything helpful for our instructors to know
Additional support details
Does your Swimmer have any of the following? ( Check all that apply)
Multi choice
Sensory sensitivities (noise, touch, water on face, etc.)
Behavioral or emotional regulation needs
Developmental delay
Physical disability or mobility consideration
Communication needs (verbal, non-verbal, visual cues, etc.)
Other
Helpful strategies or accommodations (optional)
Triggers to avoid (optional)
What helps your swimmer feel successful in new environments?
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Medical & Safety Information
Any medical conditions we should be aware of?
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No
Yes
If yes please explain
Emergency Contact
Full Name
*
Phone
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