Private Lesson Request Form

Triangle Aquatics Private Lesson Request Form

Please complete one registration form per participant.

All private lessons will be taught by an experienced instructor.

Private lesson rate: Dependent on instructor - ranges from $30-$50 per half hour. Once your form is submitted, you will be contacted with further details.

* Indicates required field

Swimmer's Name *

First

Last

Participant Age *

Lesson Type *

Private Semi-Private (if available) Both/Either

Location *

Guardian's Name (if swimmer is under 18) *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Preferred Time of Day (preferred time of day may not be available due to instructor schedules) *

Skill Level 0 - 5 (0 being cannot stay afloat, 5 being strong) *

Please Describe Swimmer's Skill Level *

Submit