Swim Lessons Registration New Participant

Please do not create a new profile in our system for your swimmer. Registration for
Group Swim Lessons is only possible after the swimmer is assigned a Program Rating / Level by the Swim Lesson Coordinator after you answer the swim skills question on the
New Participant Form.

New Participant Application

* Any swimmer whose swim ability has improved since their last group lesson session should fill out the New Applicant Form to receive an updated Program Rating / Level

Participant Name(*)

Please let us know your name.

Participant DOB(*)

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Parent-Guardian Name(*)

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Cell Phone(*)

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Email(*)

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Street Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Is swimmer a Kingsbury Club Member?(*)

Yes No

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Choose one of the following that best describes the participant(*)

Participant is between 6 months and up to 3 years old; parent/guardian is able to accompany child in water for class
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

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Other Comments (special needs, health concerns, etc.)

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PLEASE READ TERMS&CONDITIONS HERE

I agree to all terms and conditions(*)

Yes

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Group Swim Lesson New Participant Form

New Participant Application

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