JCC of Greater New Haven
Lesson Request
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Primary Contact Information
First Name
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Parent first name
Last Name
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Parent last name
Primary Phone Number
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Phone number
Secondary Phone Number
Email
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Email
Preferred Contact Method
Primary (Text)
Primary (Call)
Email
Secondary (Text)
Secondary (Call)
Participant Information
First Name
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First name
Last Name
Last name
Gender
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Sex
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F
Age
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Age
Skill Level
*
Skill level
Bubbler (non-independent swimmers who are newer to the water)
Starfish (requires assistance in the water but can swim small distances independently)
Minnow (swims independently for a moderate distance)
Stingray (able to swim at least a lap of independent freestyle, backstroke, or breaststroke)
Blue Marlin (able to swim multiple laps at a time of multiple different strokes)
Adult Beginner
Adult Intermediate (general knowledge of strokes, looking to improve technique and ability.)
Adult Advanced (pace training, swimming in intervals, and more.)
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Preferences
Location
JCC of Greater New Haven
Special Accommodations or Requests
Objectives
General Availability
Please mark the times of the day you are generally available for lessons week to week
AM
AFTN
PM
Morning
Afternoon
Evening
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Sunday
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Monday
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Tuesday
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Wednesday
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Thursday
F
Friday
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Saturday
Packages
Select Available Package
*
Package
5 Pack Private Lessons Members- $205
5 Pack Private Lessons Non Member $230
10 Pack Private Lesson Members $390
10 Pack Private Swim Lessons Non Members $440
5 Pack Semi-Private Lessons Members $125
5 Pack Semi-Private Lessons Non Members $150
10 Pack Semi-Private Lessons Members $225
10 Pack Semi-Private Lessons Non Members $250
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