Swimmer's Date of Birth *

MM

DD

YYYY

Swimmer's Name *

First Name

Last Name

Past swim skills / experiences *

Swim levels & Lesson experiences

[Level 0] None but READY to swim

[Level 1] Need a kickboard to swim (6 months or less)

[Level 2] Know how to do Freestyle w/o any help (6-9 months)

[Level 3] Advanced Freestyle and entry level Backstroke (1 year or more)

[Level 4] Finished Free & Back and working on Breaststroke (1.5 years)

[Level 5] Finished all above but Butterfly (2 years or more)

[Level 6] Pre-swim team level. Know all 4 strokes (3 years or more)

[Swim Team] ACE SWIM TEAM (Higher than Level.6)

[Synchronized swimming]

Parent's Name *

First Name

Last Name

Phone *

(###)

###

####