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Child's Name *
Child's Name
Parent/Gaurdian's Name *
Parent/Gaurdian's Name
Address *
Mon - Thurs, 30 Minute Swim Sessions Please select the session you would like to register for.
Summer Swim #1 June 17-20, 24-27 ($70.00)
Summer Swim #2 July 1-3, 8-12 ($70.00)
No lessons on July 4th, make-up July 12th.
Summer Swim #3 August 15- 18, 22-25 ($70.00)
NEW BEGINNER - Child has not had any previous swim lessons; needs to learn or improve on the following; blowing bubbles, bobs, back float, front float, back glides, intro to elementary backstroke, intro to flutter kick, and jump off side of pool to instructor. BEGINNER II - Child has had previous swim lessons- Needs to learn or improve on the following: Front and back glides, front and back floats (without assistance) elementary backstroke arms and legs, flutter kick legs, intro to crawl stroke arms, intro into regular backstroke arms, picking objects off the bottom of the pool, intro to treading water, and jumping off side of pool-swimming to wall. BEGINNER III - Child has had previous swim lesson; Needs to learn or improve on the following front and back float, glides on front and back unassisted, Front and Back glides with flutter kick, elementary backstroke arms and legs, intro to crawl stroke side breathing, Crawl stroke arms and legs, treading water, retrieval of toys off bottom of pool, jumping and swimming to side. FINS - Child has basic swim skills; can swim the crawl (freestyle), backstroke, elementary backstroke. Needs to learn or improve on the following, breaststroke, sidestroke, crawl, backstroke, elementary backstroke, treading water, retrieval of toys from bottom, shallow diving, and turns, Water games will be taught.
Skill Level *
Please select your child's current skill level.
Waiver: We, the staff at Coastal Fitness & Aquatics recognize our obligations to make parents aware of the risks and hazards associated with Swimming lessons. Children may suffer injuries, possible minor, serious or catastrophic in nature. Swim lessons can be dangerous and lead to injury, or in a serious event death. I hereby give consent to Coastal Fitness and Aquatics to provide, through a medical staff of its choice, customary medical attention, transportation, and emergency medical services as warranted by the course of my child(ren)'s participation. Parents should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and lifeguard/instructor instructions. Coastal Fitness & Aquatics and its staff members will not accept responsibility for injuries sustained by any child during the course of a children's swim program, party, competition, lesson, or camp. With the above in mind, and being fully aware of the risks and possibility of injury involved, I consent to have my child(ren) participate in the program offered by Coastal Fitness & Aquatics. I, my executors or other representatives waive and release all rights and claims for damages that I or my child may have against Coastal Fitness & Aquatics and its representatives whether paid or volunteer. I also affirm that I now have provided proper information which consider adequate for my child's protection and my own. O also understand that it's the parent's responsibility to warn the child about the dangers of injury associated with the physical activity.
By selecting "Agree", Parent or Guardian acknowledges and agrees to the terms and expectations described on this waiver.


Pool Rules and Regulations:

  • Children under 14 years old must be accompanied by an adult in the pool area

  • Children under 7 years old must be accompanied by an adult in the water

  • No personal pool toys permitted in pool except lifejackets and water wings for children

  • Swim attire only (no street or workout clothes, no street shoes)

  • No RUNNING on pool deck

  • Absolutely NO DIVING

  • Unnecessary rough-housing in the water is not permitted

  • No standing or sitting on shoulders

  • No throwing people into the air in the water

  • No jumping from the ladder areas

  • No food, beverage or chewing gum allowed in the pool area (except plastic water bottles)

  • No person under the influence of alcohol or other substances may use the pool

  • Immunodeficiency individuals should use caution when using any public or private pool

  • If you are in need of assistance, contact the lifeguard or receptionist on duty

  • No stacking kickboards together, and no standing or jumping on kickboards

  • Therapy chair lift is not to be used other than with supervision or instruction 


Lap Swim Rules:   

  • Lap lanes are first come first served

  • Please share lanes if needed

  • Adult lap swim times are open to members 18 years and older

  • Open lap swim times are open to all members able to swim laps

  • When circle swimming, swim in a counter-clockwise direction

Swim Lesson Rules/Times:

  • The warm water pool is reserved for swim lessons and participants

  • No adults are needed in the water for any Preschool or Swim lesson classes

  • Parents are required to get in the water with child for any Parent/Tot class