Registration | Calhoun Swim

Note: Payment due with Registration- Please do not complete until ready to pay.

Select Your Lesson

Parent / Guardian Information

Parent / Guardian Name

Email

Phone

Swimmer Information

Swimmer Name

Swimmer Age

Has Swimmer had lessons before?

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

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?

Medical & Safety Information

Any medical conditions we should be aware of?

No

Yes

If yes please explain

Emergency Contact

Full Name