2023 Safety First Swim School Pre-Registration

Winter Garden, FL

www.safetyfirstswim.com

321-236-0240 ext. 5

Student's Name: *

D.O.B. * +

Additional Student's Name:

D.O.B. +

Additional Student's Name:

D.O.B. +

Primary Contact First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Cell Phone Number *

Email Address *

Swim Class Options
May click different classes if there are multiple students. *

*Beginner Survival Swim 6mo-6yrs

*Refresher Survival Swim

*Maintenance Survival Lessons

*Beginner Stroke Development 4-7 years

*Beginner Survival Swim 6mo-6yrs: Student has never received survival lessons.
*Refresher Survival Swim: Student has completed the beginner survival lessons but has not had any lessons for 4 months or longer.
*Maintenance Survival Lessons: Student has completed beginner swim program or refresher survival swim in the last 3 months and wants to continue practicing survival skills and learning new skills.
*Beginner Stroke Development 4-7 years: Student is over 4 years of age, has basic survival swimming skills, like floating on back and swimming to safety, and needs to learn the basic strokes.

*The Survival Swim program is 4 days a week, 15 minutes each day Monday-Thursday for 6-8 weeks. Lessons start on a Monday and your time slot must be the same time each day. The Refresher Survival lessons usually takes 4 days a week, 15 minutes each day Monday-Thursday for approximately 3-4 weeks in order for the student to adjust to the survival skills in their bigger bodies and regain their confidence. These are billed weekly on Friday before the upcoming week.

*Maintenance and Stroke Development Lessons are either 2 days a week for 15 minutes or 1 day a week for 30 min. and require a committment for a full season (2 months). These are billed montly on the Friday prior to beginning of the month. If you wish to remain on the schedule then sign up for multiple seasons or let us know as soon as possible so we can reserve your spot.

Space is limited. Due to the demand for lessons, all students must commit to a full season. Please select your Season below:

2023 Seasons Dates
May select more than one to keep your time slot.

*

Fall Season: 7/30 - 10/8

Preferred Lesson Time Frame
Please check your season listed above for times we are teaching lessons. We will do our best to find a time slot within your time frame for your dates selected. *

Preferred Class Time:

Flexible 🛈

What is your child's previous aquatic history? e.g. will they get their face wet, do they use floaties. Any medical concerns or disabilities? *

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Emergency Contact *

Cell Number *

Reminders:

Thank you for submitting your Pre-Registration for 2023.

Safety First Swim School will be contacting you as soon as an opening is available for your preferred start date and time.

If you need immediate assistance, please visit www.safetyfirstswimschool.com for more information or call 321-236-0240 ext. 5.

For Office Use Only:

Official Start Date:_____________________ Official Start Time: _____________________