Now Accepting All Fall Private Lesson Requests! Participant Name(*) Please let us know your name. Participant DOB(*) Invalid Input Parent-Guardian Name(*) Invalid Input Cell Phone(*) Invalid Input Email(*) Invalid Input Street Address(*) Invalid Input City(*) Invalid Input State(*) Invalid Input Zip Code(*) Invalid Input Are you a Kingsbury Club Member?(*) Yes No Invalid Input Choose one of the following that best describes the participant(*) Am 3 years old at the start of the program. Can separate from parent and follow instructor directions Can glide with face underwater 3 yards and is beginning to swim independently using arms, not touching the bottom Can swim face-in freestyle (crawlstroke) with arms coming out of the water; and swim across the pool without assistance Can proficiently swim freestyle, backstroke, and breaststroke; and swim 50 yards of both freestyle and backstroke Invalid Input Only specific times you provide (earliest start time & latest start time for each day you can be at the pool: i.e. Mon 3-6 PM; Tu 8-9 AM) will be considered when placing a request with an instructor. **Submitting "flexible" or "all day" will always require follow up to obtain specific times & will delay the scheduling of your swimmer.(*) Invalid Input Please provide known vacations and other conflicts(*) Invalid Input Other Comments (special needs, health concerns, etc.) Invalid Input Terms(*) PLEASE READ TERMS&CONDITIONS HERE Invalid Input Send
