Information Sheet Current Page Please complete the information sheet below Student's Name Age Parent's Name (required) Phone Your Email (required) Address City, State, Zip How Did You Get My Name? What Has The Experience Been In The Water To Date? Is There Any Fear Of Water Or Swimming? If Yes, What Do You Attribute It To? If Swimming Lessons Have Been Received In The Past, When And Where Were Those Lessons Taken? What Was The Progress? What Would You Have Changed About The Lessons? What Skills Would You Like To Be Accomplished By The End Of Swimming Lesson Season? What Medications Does Your Child Take During The School Year? During The Summer? Are There Any Other Comments Or Concerns That You Would Like To Address? Δ
