Respondent (Parent/Guardian)*

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First name *

Last name *

Email *

Mobile *

Address *

City *

Country *

State/Province *

Zip/Postal code *

Other Parent/Guardian

First name

Last name

Email

Mobile

Swimmer (Participant/Child)*

Ages 2 to adult

First name *

Last name *

Date of birth *

List previous swim experience and goals. Please include any additional information that you'd like for us to know about the swimmer. *

Skills Checklist

Use this checklist as a guide for beginner to intermediate swimmers.

Can go underwater Can float on stomach Can float on back Can surface to take a breath while swimming on front Can kick on back Can tread water Can swim 10 meters (on either front or back)

Scheduling Preferences

We greatly appreciate your flexibility with your availability, as it enables us to better accommodate your request. Please do not skip this section, and please select all availability. Popular spots are most likely waitlisted.

Weekdays from 2 - 4 PM
Tuesdays and Fridays from 4:15 - 6:15 PM
Saturdays from 7:15 - 8:45 AM and 1:15 - 4:30 PM
Sundays from 1:30 - 4 PM

Weekday Afternoons

Monday

Tuesday

Wednesday

Thursday

Friday

2PM

230PM

3PM

330PM

Tuesday, Wednesday, & Friday Evenings

Tuesday

Wednesday

Friday

415PM

445PM

515PM

545PM

615PM

Saturday Mornings

Saturday

715AM

745AM

815AM

Saturday & Sunday Afternoons

Saturday

Sunday

130PM

2PM

230PM

3PM

330PM

4PM

Package Selection

Please select the package that you'd like. Please do not skip this section.

20 Minutes: Ages 2-3 only

30 Minutes: Ages 3+

45 Minutes: Ages 4+

20 Minutes

30 Minutes

45 Minutes

4 Lessons

6 Lessons

8 Lessons

10 Lessons

12 Lessons

For multiple children - please indicate which package is going to each child.

Adaptive Swim Lessons

We are proud providers of adaptive swim lessons. Adaptive swim lessons are for students with disabilities. We teach all abilities at CVSS. We believe that everyone deserves an equal opportunity to learn how to swim and be safe around water.

Please let us know if your swimmer has a disability so we can plan accordingly. We do not turn students away.

My swimmer has a disability and needs adaptive instruction.

Instructor Requests

We do our best to pair swimmers with their preferred instructor, but scheduling depends on both your availability and the instructor’s.