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Parent Portal
Before your first private lesson.
1
Step 1
Private Swim Questionnaire
Prior to your first Private Swim Lesson please complete the brief questionaire. It will allow our instructors to prepare a lesson plan for your child.
Childs First Name
Childs Last Name
Childs Age (at time of private class)
Date of 1st Private Lesson
date_range
If this is multi-student lesson, please list all the participants..
This is the first time my child has had swim lessons
Yes
No
My Child's Anxiety Level
pick one!
On a scale of 0-5 please rate your child's anxiety
0-No Fears; Loves the water and will try any new skill
1-Cautious: Loves the water, but is a little hesitant to try new skills
2-A little Nervous: Likes the water, but is hesitant to put their face in the water
3-Nervous: Likes the water but does not like putting their face in the water.
4-Anxious: Will enter the pool willingly but is anxious to be in the water and will not put their face in the water.
5-Very Anxious: Will need a lot of encouragement and support to enter the pool and will not put their face under water
My child can swim independently 25 ft with no flotation
Yes
No
Briefly describe your child's swim abillity
0
/
What are your goals for your child in their swim lesson(s)?
0
/
Please use this space for any additional questions/comments, and list any medical issues that may be relevant to their lesson.
0
/
Please resubmit the form if any of the information changes throughout the course of your private lessons.
Parents Name
Submit Form
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