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  

 
  Four (4) 30-minute lessons  
Fees Members Non-members
Private (one instructor / one swimmer)  $ 170 $ 190
Semi Private (one instructor / two swimmers) $ 200 $ 225
     
 



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