2023 Swim Lesson Registration – Non Members – Cedarbrook Swim and Tennis Club

Parent/Guardian Name(Required)

First Last

Email(Required)

Phone(Required)

Name – Swimmer #1(Required)

First Last

Age of Swimmer #1(Required)

Swim Ability Group – Swimmer #1(Required)

Group 1: Pre-Beginner

Group 2: Beginner

Group 3: Advanced Beginner

Group 4: Pre-Swimmer

Group 5: Swimmer

Group 6: Stroke Development & Endurance

Please see the Group Ability Descriptions here: https://cedarbrookclub.org/lessons-programs/swim-lessons/

Product Name

Swimmer #1 Date(s)(Required)

Week I: June 19- June 22 (10:45-11:15)

Week I: June 19- June 22 (11:20-11:50)

Week II: June 26 – June 29 (10:45-11:15)

Week II: June 26 – June 29 (11:20-11:50)

Week III: July 3, 5, & 6 (10:45-11:15) *No lessons July 4th

Week III: July 3, 5, & 6 (11:20-11:50) *No lessons July 4th

Week IV: July 10 – July 13 (10:45-11:15)

Week IV: July 10 – July 13 (11:20-11:50)

If you have multiple swimmers, please add them on the following page!

Swim Lesson Subtotal

$0.00

Online Processing Fee

Price: $0.00

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

2023 Swim Lessons – Non-members