Compass Learning Advantage -

Swimming Inquiry Form

Please let us know a little more information about what you are looking for in a swim lesson

Parent's First Name*

Parent's Last Name*

Email*

Phone*

Child's Full Name*

Child's Date of Birth (MM/DD/YYYY)*

What age range are you looking for?*

3 and under

4-6

7-13

14-18

Adult

What dates and times are you available for lessons?

Monday- 4-6

Tuesday- 4-6

Thursday- 4:30-6:30

Saturday- 9-12

Another date/time

If other, please let us know what additional days and times you are available.

Does your child have an IEP or 504 plan?

Are you looking for group or private lessons?

Group (4:1)

Private (1:1)

Share about your experience with swimming. (with other swim programs, general swim abilities, interests in swimming or needs with swimming).*

What are your goals for your swimming experiences?*