Youth Group Swim Lessons

Interest Request Form

Sharpen your child's swimming and water safety skills! Our small group ratio allows children to practice social distance with personal protective equipment. Select the day and time you would like your child's swim lessons and we'll contact you to get everything set up!

Swim lessons spots are limited. Please submit your interest request form as soon as possible to guarantee enrollment.

If you have any questions please email ChrisS@JCConline.com or call 561-259-3008.

JSwim Policies and Procedures

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Your Information

Email*

First Name*

Last Name*

Address*

City*

State*

ZIP Code*

Phone*

Second Phone

Date of Birth (of parent registering child)*

Child 1 Name

Child 1 Age

What is your child's swimming experience?

Monday Swim Lessons

Tuesday Swim Lessons

Wednesday Swim Lessons

Thursday Swim Lessons

Friday Swim Lessons

Select Your Swim Lesson Session

Saturday Swim Lessons

The following people are authorized to pick up my child (If parent or guardian are unavailable. Maximum of 3):

Comment / Other Notes

Check this box to agree to the JSwim Policies and Procedures listed above.*

* Required information

Youth Group Swim Lessons

Interest Request Form

JSwim Policies and Procedures

Your Information

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