Home Pool Schedule Hodder Memorial Centre Summer Sports Bowling Pool Private Lessons Lessons Info User Registration Cart Private Lesson Registration Name Swimmer's Details Let us know your information, so we can get back to you Swimmer First Name * Swimmer Last Name * Age of Swimmer * Highest Level Swimming Completed * PreSchool 1 PreSchool 2 PreSchool 3 PreSchool 4 PreSchool 5 Swimmer 1 Swimmer 2 Swimmer 3 Swimmer 4 Swimmer 5 Swimmer 6 Rookie Ranger Star Bronze Medallion Bronze Cross Unknown has your child participated in swimming before? if so, what level was completed? What Lesson were you looking for * Parent & Tot 1 Parent & Tot 2 Preschool 1 Preschool 2 Preschool 3 Preschool 4 Preschool 5 Swimmer 1 Swimmer 2 Swimmer 3 Swimmer 4 Swimmer 5 Swimmer 6 Rookie Patrol Ranger Patrol Star Patrol Bronze Medallion Bronze Cross Unknown select the lesson level Preferred Date Block # 1 Block # 2 Block # 3 Notes List out any skills you would like worked on. Medical Conditions? * does your child have any medical conditions we would need to be aware of? if so list them here Helper in water? * Will your child require a helper in the water with them? if so what is the helpers name and relation to the child? Parent/ Guardian Details Let us know your information so we can inform you of updates or schedule changes Parent/ Guardian 1 Name * Parent/ Guardian 2 Name Email Address * Other Email Address Phone Number * Other Phone Number
