Adaptive Aquatics Waitlist Form

This form is will help us to match up our swimmers with our instructors. Please take a moment to answer the questions below.

Adaptive Swim lessons are for members of our community with Special Needs.

**Please note: this is NOT a registration form and by filling this form out it does NOT guarantee your spot in lessons.**

If you have any questions, please reach out to Rich via the contact information below.

Thank you!

Swimmer's Info

Parent/Guardian's Info

Please select the swimmer's availability from the following options:

Additional Questions