Private Swim Lesson Request
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Private Swim Lesson Request
Returning swimmer?
yes
no
Parent MACAC member?
yes
no
Child MACAC member?
yes
no
Student
First Name
Last Name
Sex
Address
Zip
Home Phone
Work Phone
Student Age
Birthdate
Parent
First Name
Last Name
Swim Team
Comments
Return email
* required for confirmation
Select Month
January
May
September
February
June
October
March
July
November
April
August
December
Select Level:
(course descriptions)
Parent and Child
Preschool 1
Preschool 2
Preschool 3
6&7 swim team
Level One
Level Two
Level Three
8+ Strokes
Level Four
Level Five
Level Six
Teen A (12-16 Yrs) (2 swimmers)
Teen B (12-16 Yrs) (4 swimmers)
Adult Beginner/Novice (13 Yrs +)
Adult Intermediate/Advanced (13 Yrs +)
Select Time Preference:
8:00 to 11:00 am
1:00 to 3:00 pm
5:00 to 8:00 pm
11:00 to 1:00 pm
3:00 to 5:00 pm
Fees
Members
Non-members
One to One Instruction; Four (4) 30-minute lessons
$ 160
$ 177
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