Survival Swim Lessons Signup Form

Class fees are $840 per child, per 6 week class for 24 private Survival Swim Lessons. There is a one-time $50 registration fee to hold your place. No credit card required today.

For any questions not answered by our Lessons page, please feel free to contact us.

All fields are required unless otherwise indicated.

YOUR NAME & CONTACT INFO

Your name (First, Last)

Your email

Your phone number

Your location (city)

What is the best way for us to get in touch with you?

CHILD'S INFORMATION

Child's name (First, Last)

Child's age

Has the child previously had swimming lessons?

What is your relationship to the child?

Relationship if "other":

Does your child have any special needs? (We work with all ages and abilities.)

Please share a brief description of how your child learns best (if applicable):

What best describes the reason for your interest in survival swim lessons?

CLASS DETAILS

Which class are you signing up for? Select all that apply.
(For details, review our class options at knoxvillesurvivalswim.com/survival-swim-lessons.)

What is your preferred class time?

How do you plan to pay for classes?

ADDITIONAL INFO

How did you hear about us?

Who can we thank for referring you (optional)?

Any additional comments, questions or details? (optional)