Swimmer's Name *

First Name

Last Name

Two Swimmers? *

Yes

No

Parent's Name

First Name

Last Name

Phone

To help with any scheduling changes and more direct communication.

(###)

###

####

Choose Desired Pool Location

Leave blank if you have no preference.

Snohomish Aquatic Center

Lake Stevens High School Pool

Custom

Swimming Abilities *

This swimmer CAN swim on their own without an instructor in the water.

This swimmer CANNOT swim on their own without an instructor in the water.

Not Sure

Swim Lesson Experience *

Has this swimmer done swim lessons before?

Yes

No