Private Swim Lesson Interests

Private Swim Lesson Interest Waitlist Form

Please complete the following interest and waitlist form and a YMCA staff member will be in touch to get you started with private swim lessons! This is an interest expression form and not a program registration. Our staff will be in contact to get you started within 2 weeks.
Parent/Guardian Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
I'm interested in private lessons at*

DailyDickensonHutchersonOkmulgeeOwassoTandy
My preferred days and times are*
My choice of preferred days (please pick 3):*

MondayTuesdayWednesdayThursdayFridaySaturday
My choice of preferred times:*

10 - 12 pm4 - 6 pm6 - 8 pm
I'm interested in private lessons for *

1 individual with 1 instructor2 individuals with 1 instructor
Participant #1 Name*

First NameLast Name
Age*
Gender*

FemaleMalePrefer not to answer
Swim Ability*

Total beginner with a fear of waterBeginner ready to jump in and learnAble to float and kick but can't swim the length of the poolCan pass the swim test and wants to learn advanced swim strokes
Participant #2 Name*

First NameLast Name
Age*
Gender*

FemaleMalePrefer not to answer
Swim Ability*

Total beginner with a fear of waterBeginner ready to jump in and learnAble to float and kick but can't swim the length of the poolCan pass the swim test and wants to learn advanced swim strokes
Please use this space below to share any other information you feel our aquatic staff should know regarding your private swim lesson request (optional):
Should be Empty:

Private Swim Lesson Interest Waitlist Form