Fillable PRIVATE SWIM LESSON REQUEST FORM

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PRIVATE SWIM LESSON REQUEST FORM

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PRIVATE SWIM LESSON REQUEST FORM
RATES
Private 30 Minute Lesson - $40
Semi-Private 30 Minute Lesson - $30 per person
Semi-Private Lessons are limited to 2 participants per lesson. Participants must be the same ability level.
SWIMMER INFORMATION
TODAY’S DATE: LESSON TYPE (select an option from the list above): _______________
SWIMMER’S NAME: ________________________________ AGE: _____
SWIMMER’S ABILITY LEVEL: ___ Beginner ___ Intermediate ___ Advanced
Please describe:
• Swimmer has had previous swim lessons or experience? ___ YES ___ NO
• Is the swimmer comfortable in the water? ___ YES ___ NO
• Does the swimmer feel comfortable putting head underwater? ___ YES ___ NO
• Can the participant swim independently without a floatation aid? ___ YES ___ NO
• Can the participant swim the length of the pool (25-yards) without aid or assistance? ___ YES ___ NO
Basin Recreation welcomes participation of all individuals including those with disabilities or special needs. We are committed to compliance with the ADA and will provide reasonable accommodations to facilitate participation
in our programs. To ensure reasonable accommodations are in place, program registration or accommodation requests should be received by management at least two weeks prior to desired start date of private swim lessons.
PLEASE LIST ANY ADDITIONAL INFORMATION ON SWIMMING LEVEL, PERSONAL GOALS, DISABILITY, OR REASONABLE
ACCOMMODATION REQUESTS:
PREFERRED BASIN INSTRUCTOR: ___________________________
NO PREFERENCE:
CONTACT PERSON OR PARENT/GUARDIAN NAME: _________________________________________________
EMAIL: ___________________________________________ PHONE: ___________________
Please read the following and sign below:
1. Children must be at least 3 years of age in order to participate in private swim lessons alone.
2. Submitting this request does not guarantee lessons. Requests are filled based on availability.
3. Requests are received and filled in the order in which they are received.
4. Please allow up to 1 week to find an instructor for your lesson.
5. Regular Basin Recreation Fieldhouse and Facility rules and schedules apply.
SIGNATURE: ______________________________________________ DATE: _____________
Please return this document to The Fieldhouse Front Desk or email to: fhprograms@basinrecreation.org
AQUATICS MANAGEMENT USE ONLY:
RECEIVED DATE: ____________ BY: __________________ CONTACT DATE: _______________
PRIVATE SWIM LESSON RULES AND GUIDELINES AGREEMENT
Thank you for your interest in Private Swim Lessons at Basin Recreation. This form will help you understand our policies and procedures for Private Swim Lessons.
We offer 30-minute private and semi-private lessons to our patrons according to the pricing listed on our website and request form.
Private and Semi-Private Lessons are available and scheduled on an individual basis. Private Lessons will not be scheduled for or
conducted during the same time as other aquatics programs at The Fieldhouse. Reservations are set on a first come first service basis
and scheduled according to pool space and instructor availability. A Private Lesson Request Form and Agreement must be completed,
and payment must be received prior to conducting private or semi-private lessons.
If you have a preference it is possible to request specific instructors from our current staff roster. We will do our best to honor these
requests, but we cannot guarantee that we will be able to fill every request for a specific instructor due to scheduling constraints.
LESSON REQUEST PROCESS
1. Fill out the Private Swim Lesson Request Form and either submit it to the front desk, or email it to
fhprograms@basinrecreation.org. The request form must be filled out completely and signed in order to be considered.
2. Within 48 hours during the regular business week, you will receive an email acknowledging that the request form has been
received.
3. Kim Isleib, the Recreation Administrative Assistant, will then review the instructor’s and facility’s availability to see if your
requests match private lesson availability.
4. Once an instructor has an available time slot that matches closely with your request, Kim will contact you via phone or
email in order to set-up your reservation dates and times.
5. All correspondence related to these Private Swim Lessons will be set up ONLY through the Recreation Administrative
Assistant.
6. Payment for lessons must be made before the reservation is finalized, either at the Front Desk or over the phone at
(435) 655-0999 extension 14.
If there is not currently an opening available for private lessons, you will be contacted, and this completed form will remain in the
aquatics department until an instructor has an available slot that matches your availability.
If you wish to have another session of private or semi-private lessons after the scheduled classes end, you must submit a new private
lesson request form to the coordinator.
CANCELATION/NO-SHOW POLICY
Full credits/refunds will be given if notice of cancellation is provided seven (7) or more days prior to the first day of a program. For
purposes of this policy, the start of a sports program is defined as the date of the first scheduled practice. Eighty percent (80%) of the
paid fee will be credited or refunded if notice of cancellation is given within seven (7) days of the start of the program. Programs
canceled by the District will be refunded in full. This general policy applies to day camps, sports camps, bike camps, clinics, and
programs. There are no credits or refunds for inclement weather.
If a lesson is canceled by the instructor, the staff member will make reasonable efforts to contact you as soon as possible. A make-up
lesson will be scheduled. A credit will be issued to your account if a make-up lesson cannot be scheduled.
The participant is expected to be punctual and understand that the instructor may have appointments immediately preceding or
following your lesson. The instructor is not obligated to stay past the allotted time scheduled for your private lesson.
Please sign and date acknowledging that you have read and understand the above information:
SIGNATURE: _____________________________________________________ DATE: ________________
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PRIVATE SWIM LESSON REQUEST FORM

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Completed 20 April 2022

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