Swimming Lesson Registration | Harbor Square Athletic Club

Registrant

Parent's Name (or adult swimmer's name)*

Children's Names and Ages*

Name	Age

Please click the "+" icon to add more children.

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

HSAC Member (barcode) #

Your Availability (give broadest range possible)*

Days & Times

Previous Instructor's Name (only if at HSAC)

Your Swim Level (only if at another location)

Amount of Lessons*

Lesson Type*

What is the earliest time you could attend a lesson?

Looking for weekend lessons?

Instructor Preference(s)

Do you have any additional comments or questions?