Semi-Private Lessons

Anderson Mill Limited District
PrivateLesson Form

Private Lessons

50 min - $50

Semi-Private Lessons

(Limit of 2 swimmers per lesson)

50 min - $70

Applicant Information

Parent/Guardian: ______

First & Last Name

1ST Swimmer: ______

First & Last Name Date of Birth

2ND Swimmer: ______

First & Last Name Date of Birth

Address:______
StreetCityZip

HomePhone: ______Cell Phone:______Email:______

Lesson Information

Lesson Date & Time (During Open Hours ONLY): ______

Name of Instructor: ______

Private lessons must be scheduled with the instructor in advance.
The parent must check-in with the cashier and pay for each lesson upon arrival.
There are no refunds for private lessons.
There is no charge for parents to watch the lessons; however, you must pay the daily drop-in fee or purchase a pool membership for each additional child or adult that accompanies you during the lesson.
Children 6 & under must have anadult within arm’s reach of them at all times, if they are not in a lesson.
If you wish to come to the pool to practice, play, or stay after your scheduled lesson, you will need to pay the daily drop-in fees of $5 for adults and $3 for children 17 & under or check in with your annual pool membership.

Be sure to read and sign below: I hereby agree to indemnify and hold harmless the Anderson Mill Limited District and its officers and employees from and against any and all liabilities for any injury which may be suffered by me or by my child arising out of or in any way connected with participation in the program noted above. In case of emergency, my child may be treated by a qualified first responder and/or a physician/EMS member. I give Anderson Mill Limited District the right to photograph and use the likeness of myself or my child.
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SignatureDate

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OFFICE USE ONLY