Geneva Lakes Family YMCA

Private Lesson Request

We are pleased you are contacting The Geneva Lakes Family YMCA for your private lesson swim needs. We want to provide a quality program that meets your personal swim goals so please take a moment to complete this form.  Once you submit this document at the end, it will be sent directly to our Aquatics Coordinator to review and follow-up with you.  Please give us up to 48 hours to respond. We look forward to talking with you! Thank you!  

Parent First Name
Parent Last Name
Parent Phone (xxx-xxx-xxxx)
Parent Email
Are you a:
 Member
 Community Participant
Swimmer's Name
Swimmer's Age
Second Swimmer's Name (if applicable)
Second Swimmer's Age: (if applicable)
Goal for lesson:
Days available:
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday
Desired start time:
How did you hear about the Private Lesson program?
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