Beginner Swimming Skills Checklist
Use this form to record and assess beginner swimming skills for each participant.
Participant Full Name
*
First Name
Last Name
Age
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Instructor Name
*
Beginner Swimming Skills Checklist
*
Comfortable entering and exiting the water
Able to submerge face and blow bubbles
Can float on back with support
Can float on front with support
Can kick legs while holding onto pool edge
Can glide with support for a short distance
Other
Overall confidence in water (1 = Not confident, 5 = Very confident)
1
1
2
3
4
5
5
1 is 1, 5 is 5
Additional Comments or Observations
Submit Checklist
Should be Empty: