Private Swim Lessons Request Form

AVSP offers both private and semi-private (two person) swim lessons. Lessons are 30 minutes and may be bought individually or in a package of 5. Please note that once the packages are bought and started, they are non-refundable and non-transferable. Please complete the information below and someone from the AVSP staff will contact you.

I am a Member of the AVSP? *

Yes

AVSP Member #: *

Parent First Name: *

Parent Last Name: *

Email Address: *

Telephone #: *

Enter student information below:*

	1st Swimmer	2nd Swimmer
First Name	1st Swimmer	2nd Swimmer
Last Name	1st Swimmer	2nd Swimmer
Age	1st Swimmer	2nd Swimmer
Swimming Experience	1st Swimmer	2nd Swimmer

Availability (please be aware of the time restrictions for each day):

	1st Student	2nd Student
Monday (10:30am-4:15pm) Evening is very limited	1st Student	2nd Student
Tuesday (10:30am-415pm & 6-8pm)	1st Student	2nd Student
Wednesday (10:30am-415pm) Evening is very limited	1st Student	2nd Student
Thursday (10:30am-4:15pm & 6-8pm)	1st Student	2nd Student
Friday (10:30am-4:15pm & 6:45-9:00pm)	1st Student	2nd Student
Saturday (11pm-7:30pm ONLY)	1st Student	2nd Student
Sunday (7am-6pm ONLY)	1st Student	2nd Student

Please select what time you are available: *

Either

Do you want Private or Semi-Private (max 2 students) lessons? *

Private

Semi-Private

How many lessons are you interested in?: *

Additional Information/Special Needs: