This form is for onboarding parents for New - Private Survival Swim Lesson registrants in Ansonia ONLY. If you would like to be a new customer and are looking for information on our program, please email us directly at [email protected] so we may add you to the waitlist.
For all others that have already been in contact with us and are actively being scheduled, please complete all 4 boxes to begin registration for our ANSONIA location.
REMINDER: ONLY ONE PARENT PER FAMILY
First Name
 
Last Name
 
Email Address
Phone Number