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Pasadena Private Swim Lessons Request Form

Thank you for your interest in Big Vanilla’s Private Swim Lesson Program. Please complete the online form below and submit the online private lesson information request to the Aquatics Director, Shelly Beigel, who will then forward it to one of our private swim lesson instructors. You should receive a phone call or email within 48 hours of your request. If you have any questions please feel free to contact Shelly Beigel at 410-437-4242.

Shelly Beigel
Aquatics Director
sbeigel@bigvanilla.com
410-437-4242

PARTICIPANT CONTACT INFORMATION

Name: (First and Last Name)

Street Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Best time to call:

Email:

How do you prefer us to contact you to plan the private swim lessons? Phone Email

Parent's Name, if student is child: (First and Last Name)

Child's Age

Child's Date of Birth:
(00/00/0000)
Child's Sex: Male Female

Special Needs, Injuries, or Conditions:

What are you interested in learning?

Request Instructor? (fill in box, if you know the instructor's name):

Preferred Days:

Preferred Times (note a.m. or p.m.):

Days of week:

1 person $30/half hour
2 persons $40/per half hour
3 persons $45/per half hour

Last updated on April 29, 2010.

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