Private swimming lessons request

Submitting this form does not guarantee registering for private swimming lessons. Staff will review your request, and reach out to you to discuss scheduling options and how to pay. If you have not heard from us within five business days of submitting your request, please contact the Cowichan Aquatic Centre at 250-746-7665.

Participant's full name

Participant's birth date

Parent or guardian's name

Please provide your name if the participant you are requesting private lessons for is under the age of 18.

Phone number

Email address

What is the participant's current swimming ability?

Has the participant previously taken swimming lessons?

Yes

What swim level have they completed?

Are you interested in private (1 swimmer) or semi-private (2 swimmers) lessons?

Private

Semi-private

Please describe what makes a private one-on-one swimming lesson a good fit for the participant?

What are your main goals for private lessons?

Is there anything our swim instructors should know about the participant that would help us provide an effective lesson?

What days of the week and times are you available for private lessons?

Select all that apply. Note - exact days and times depend on instructor and pool availability.

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Private swimming lessons request