Wall Aquatic Center

Semi-Private Swim Lessons (Summer)

/ Date:
Assigned Instructor:
Package (circle one): / A (4) ~ B (8) ~ C (12)
Amount Paid:
OFFICE USE ONLY
Participants Names: / Ages:
Parent/Guardian Name: / Message Phone:
Email: / NAU Student? / Yes  No
Mailing Address:
City: / State: / Zip:

Thank you for your interest in semi-private swim lesson at the Wall Aquatic Center. Semi-Private swim lessons are available for all ages and all skill levels - whether you are just learning to swim or wanthelp refining your stroke.

Initials

______

______

______

______

  1. All private lessons are 30 minutes. Students must be close in age and/or ability.
  2. Packages are designed as follows:2 students3 students

Package A4 lessons$100.00$120.00

Package B8 lessons$160.00$180.00

Package C12 lessons$200.00$225.00

  1. There is no guarantee that we will be able to match an instructor with you. We do our best to accommodate all semi-private swim lessons, but sometimes schedules do not match. You will be contacted within five (5) business days of completing the information packet if we can match you with an instructor.
  1. Semi-Private swim lessons run only during normal hours of operation at the Wall Aquatic Center. Hours are subject to semester, team, and group lesson schedule.*No Semi-Private swim lessons available during group lesson times or NAU Swim & Dive times.*

Please indicate your availability for lessons, draw an (X) through the appropriate time slots (times you are available). The more flexible the availability the better. The instructor will contact you to confirm times.

Time / Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
9:00 am / N/A / N/A / N/A / N/A / N/A
9:30 am / N/A / N/A / N/A / N/A / N/A
10:00 am / N/A / N/A / N/A / N/A / N/A
10:30 am / N/A / N/A / N/A / N/A / N/A
11:00 am / N/A / N/A / N/A / N/A / N/A
11:30 am / N/A
Noon / N/A
12:30 pm
1:00 pm
1:30 pm
2:00 pm
2:30 pm
3:00 pm
3:30 pm
4:00 pm / N/A / N/A / N/A / N/A
4:30 pm / N/A / N/A / N/A / N/A
5:00 pm / N/A / N/A / N/A / N/A
5:30 pm / N/A / N/A / N/A / N/A
6:00 pm
6:30 pm
7:00 pm
7:30 pm
8:00 pm

Wall Aquatic Center

Semi-Private Swim Lessons

Questionnaire

1. What is your current swimming skill level?

2. What goals you would like to accomplish through private instruction?

3. Please inform us of any other pertinent information.

PROGRAM POLICIES &INFORMED CONSENT

Initials

______

______

______

______

______

______

______

______

  • Payment is due at the first lesson
  • Cancellation policy: 24 hour notice must be given to avoid being charged for the lesson
  • Individual make-ups are prohibited. The entire lesson is either given or cancelled.
  • The Wall Aquatic Center is not responsible for lost or stolen items.
  • Please arrive a few minutes before your first lesson to speak with the instructor.
  • Parents are advised to arrange drop-off of their child participants immediately prior to the start time of lessons, not earlier, and to remain in the building during the lesson. The Aquatic Center does not provide supervision for child participants outside of scheduled lesson times.
  • The Aquatic Center and NAU is not responsible for the safety of participants outside of scheduled lesson times.
  • The Wall Aquatic Center and Northern Arizona University do NOT provide insurance for your child/self while participating in this program. We strongly recommend that all participants carry medical and accident coverage through an individual or family health program.

I/WE GIVE PERMISSION FOR, ______, TO PARTICIPATE IN THE NAU WALL AQUATIC CENTER’S SEMI-PRIVATE SWIM LESSONS DESCRIBED IN THE ACCOMPANYING MATERIALS.

I/WE HAVE READ THE ACCOMPANYING PROGRAM(S) POLICIES AND PROCEDURES IN ADDITION TO THE GENERAL AQUATIC CENTER GUIDLINES. I/WE UNDERSTAND AND AGREE TO ABIDE BY SAID POLICIES AND GUIDELINES AND FURTHER UNDERSTAND THAT NORTHERN ARIZONA UNIVERSITY AND CAMPUS RECREATION SERVICES RESERVES THE RIGHT TO DISCONTINUE ANY INDIVIDUALS PARTICIPATION IN THE PROGRAM FOR FAILURE TO ADHERE TO THE PROGRAM POLICIES AND GUIDELINES. I/WE ASSUME ALL THE FOREGOING RISKS AND ACCEPT PERSONAL RESPONSIBILITY FOR ANY DAMAGES FOLLOWING ANY SUCH INJURY, PERMANENT DISABILITY, PROPERTY DAMAGE, OR DEATH OF MY CHILD. I/WE ACKNOWLEDGE THAT CAMPUS RECREATION SERVICES, NORTHERN ARIZONA UNIVERSITY, THE STATE OF ARIZONA, THE GOVERNOR, THE BOARD OF REGENTS, OR ANYONE CONNECTED WITH CAMPUS RECREATION SERVICES MAY NOT BE HELD LIABLE IN ANY WAY FOR ANY OCCURRENCE IN CONNECTION WITH THE SUMMER YOUTH PROGRAMS WHICH MAY RESULT IN INJURY, DEATH, OR OTHER DAMAGES TO ME OR MY FAMILY, HEIRS OR ASSIGNS.

Participant Signature: / Date:
Parent/Guardian Signature: / Date: