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803-782-3559
4135 Rockbridge Rd, Columbia, SC 29206
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Parent and Swimmer Information
Parent Name
*
First
Last
Phone
*
Email
*
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Swimmer Name
*
First
Last
Age at the time of lesson
*
Date Of Birth
*
MM slash DD slash YYYY
Swim Level
*
We adhere to the American Red Cross's Learn-to-Swim program, which has six levels. Please indicate the best level for your child.
Please select
Level 1: Introduction to Water Skills
Level 2: Fundamentals of Aquatic Skills
Level 3: Stroke Development
Level 4: Stroke Improvement
Level 5: Stroke Refinement
Level 6: Swimming and Skill Proficiency
Session Selection
Available Sessions
*
Please select
Session 1: Morning
Session 1: Afternoon
Session 2: Morning
Session 2: Afternoon
Session 3: Morning
Session 3: Afternoon
Once a session is full, it will not appear in the choices above. To be added to the waitlist please click here:
https://salesdemo2023.explore.membersplash.com/swim-lesson-waitlist/
Waivers
Waiver #1
*
{Waiver terms here}
I have read and agree to the release.
Payment
Swim Lesson (1 Week)
Price:
Total
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
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Month
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Year
Year
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