Are you interested in swimming lessons for the summer season?

We have certified lifeguards that are interested in providing swim lessons throughout the summer.

Please fill out the form below, and we will get back to you to schedule lessons.

Please contact us with any questions.

Swim Lessons Request Form

Parent/Guardian First Name

Parent/Guardian Last Name

Phone Number

Email

Swimmer 1 First Name

Swimmer 1 Last Name

Swimmer 1 DOB

Please enter your scheduling preferences:

Agreement:

Please read the following statements and check each one, indicating that you have read and fully understand them. If you have any questions, please contact us.

I understand that submission of this form is a REQUEST and that it is subject to approval by the Antioch Recreation Association Board.

I understand that a board member will contact me to finalize my registration and arrange payment details.

Electronic Signature

Please type your First and Last Name

Date

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.