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 Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
I'm interested in private lessons at
*
Daily
Dickenson
Hutcherson
Okmulgee
Owasso
Tandy
My preferred days and times are
*
My choice of preferred days (please pick 3):
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
My choice of preferred times:
*
10 - 12 pm
4 - 6 pm
6 - 8 pm
I'm interested in private lessons for
*
1 individual with 1 instructor
2 individuals with 1 instructor
Participant #1 Name
*
First Name
Last Name
Age
*
Gender
*
Female
Male
Prefer not to answer
Swim Ability
*
Total beginner with a fear of water
Beginner ready to jump in and learn
Able to float and kick but can't swim the length of the pool
Can pass the swim test and wants to learn advanced swim strokes
Participant #2 Name
*
First Name
Last Name
Age
*
Gender
*
Female
Male
Prefer not to answer
Swim Ability
*
Total beginner with a fear of water
Beginner ready to jump in and learn
Able to float and kick but can't swim the length of the pool
Can 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):
Submit
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