YMCA of Youngstown - Private Lesson Request Form

Please fill out the form below. Someone will contact you when an instructor becomes available. If you have any questions, please reach out to our Aquatic Coordinator at 330-480-5656 ext. 250.

Private Lesson Prices:

Private Lesson (one 30 minute session for 1 participant):

$20 (members)/$30 (non-members)

Semi-private Lesson (one 30 minute session for 2 participants):

$17 per participant (members)/$25 per participant (non-members)

Skill Level Selector:

To help us better serve you, please view our Lesson Selector here to best answer the “skill level” question later in the form. This skill level is just meant to be an estimate, so do not overthink it. Your assigned Instructor will assess the participant at the first lesson.

* Required

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Primary Contact Information

First Name *

Parent first name

Last Name *

Parent last name

Primary Phone Number *

Phone number

Secondary Phone Number

Email *

Email

Preferred Contact MethodPrimary (Text) Primary (Call) Email Secondary (Text) Secondary (Call)

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Participant Information

First Name *

First name

Last Name

Last name

Gender *

SexM F

Age *

Age

Skill Level *

Skill levelLevel 1: Water Acclimation Level 2: Water Movement Level 3: Water Stamina Level 4: Stroke Introduction Level 5: Stroke Development Level 6: Stroke Mechanics Unknown

REMOVE PARTICIPANT

ADD PARTICIPANT

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Preferences

LocationCentral YMCA Davis Family YMCA Either Davis or Central

Special Accommodations or Requests

Objectives

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General Availability

Please mark the times of the day you are generally available for lessons week to week

	AM	AFTN	PM	Morning	Afternoon	Evening
S	Sunday
M	Monday
T	Tuesday
W	Wednesday
R	Thursday
F	Friday
S	Saturday

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Packages

Select Available Package *

PackagePrivate Lesson Semi-private Lesson

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