UNIVERSITY CITY YMCA PRIVATE SWIMMING LESSONS REQUEST

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1 UNIVERSITY CITY YMCA PRIVATE SWIMMING LESSONS REQUEST Policy: The University City YMCA seeks to teach swimming and water safety to as many students as possible through our group lesson program. As a supplement to that, the University City YMCA offers private and semi-private swimming lessons. Procedure: The adult student or parent of students under 18 years old will complete this form and the Member Service staff person will detach & handout participant guidelines; then place it in the Aquatic Director's box. They will then contact the parent or adult student directly. Payment must be made before the beginning of the first lesson. Please allow up to 2 weeks minimum for start time of private lessons. Instructors: Lessons are taught by our swim instructors; you may request an instructor of your choice. Payment: Shall be attached to the request form or paid for before the beginning of the lesson. Please sign below if you have read and understand the participation guidelines for Private Swim Lessons. SWIMMER'S NAME SEX AGE ADDRESS ZIP PARENTS' NAME(S) HOME PHONE WORK OR CELL PHONE NUMBER OF LESSONS REQUESTING: WHY REQUESTING PRIVATE LESSONS /SPECIFIC SWIMMER NEEDS: TIME & DAY REQUEST (Specify with "X" AND the TIME FRAME that works) Monday Tuesday Wednesday Thursday Friday Saturday Sunday OTHER / # of lessons (Specify day/time frame) SIGNATURE Participants to Keep Participation Guidelines: / / DATE Cancellation: Parent or adult student must notify Instructor via phone at least 4 hours in advance of scheduled class to cancel. If you cannot reach the instructor you will need to get a message to the front desk, If the 4 hour notice is not given to the instructor before cancellation, the lesson WILL NOT be made up. Lessons must be completed within 6 months of the start date. For Participant's Use Name of Instructor: Phone # Dates/Times of Lesson(s) Requesting: YMCA Mission:To put Christian principles into practice through programs that build healthy spirit, mind, and body for all.

2 For Instructor Use ONLY Name of Instructor: Day(s): Dates/Times of Lesson(s) Requesting: Missed Dates/Why Times: Turn in to Aquatics Director when completed. Parent's Signature: Swim Lesson Instructor has reviewed the Private Swim Lesson Guidlelines.

3 Private Lesson Guidelines: Please allow a 2 week minimum to find an instructor for your lessons. Participant Private Lesson Handout Cancellation: Parent or adult student must notify Instructor via phone at least 4 hours in advance of scheduled class to cancel. If you cannot reach the instructor you will need to get a message to the front desk, If the 4 hour notice is not given to the instructor before cancellation, the lesson WILL NOT be made up. Instructor: The session must be completed within 6 months of the start date. Phone: Aquatics Hotline: Please call the hotline at for updates on pool closing/program cancellations/pool temperature. The hotline will be updated 30 minutes before your scheduled class. If the hotline is not updated, there are not updates to give; the pools are open, come swim. Can my child swim before/after class: All children under 13 must pass a swim test in order to enter the pool before or after class. See Swim Assessment above. Non-members will not be able to swim before/after swim lessons. Swim Attire: Swim suit: made of water resistant material marked for the purpose of swimming, including a built in liner. Excluding: Basketball shorts, T-shirts, denim, cotton. Un-toilet trained children: Swim diaper, plastic pants, and under a proper swim suit. Age Policy: All children under the age of 13 MUST be swim tested in our pools. Individuals over age 13 who show signs of struggle will also be asked to pass a swim test to be in deep water. Swim Assessment: Ask our lifeguard or review our swim assessment policy located on the pool deck. A yellow band swimmer must swim 15 yards and float on their stomach and back comfortably. - Must stay in appropriate locations and have active adult supervision at all times. A green band must swim 25 yards of the pool with a horizontal forward moving stroke on their stomach, jump in and tread water for 60 seconds in the deep end. - Must stay in appropriate locations and have active adult supervision at all times. - ONLY a green band child ages may be allowed to stay unattended in the pool area, as long as the parent Children are responsible for bringing their band to swim every time. If a band is lost or forgotten, you must pay $1 at the front desk for a new one. Pool Rules: Non-swimmers must be within arms reach of an adult. Only 2 non-swimmers per 1 adult at a time. Inflatables are prohibited, only US Coast Guard approved rescue equipment is allowed. Pool equipment must be used properly. Follow other rules from Lifeguard or posted.

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