EZ Swim Aquatics – Suffolk County Long Island

PRE-REGISTER FOR SWIM CLASSES

Please complete the information requested below to begin your registration process. One of our instructors will contact you within 24 hours to discuss your scheduling needs and complete your registration.
All students from last summer will receive priority on scheduling times if the contact us before May 31.

Parent/Guardian Information (items with asterisk * are required for pre-registration)

Registration Status: New Family     Returning Family *Student from last summer
First Name* Last Name
Main Phone* Work Phone Cell Phone
Address
City State Zip Code
   
       
Email* Confirm Email
What town would you like to schedule lessons:*   How did you hear about us?  

Swim Student 1

First Name
Birth Date (MM/DD/YYYY)
Gender Male Female
Program:
  Infant/Toddler
Pre-Schooler
Beginning
Intermediate/Adv
Young Adult
Adult
Preferred Class Time (1st Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Preferred Class Time (2nd Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Preferred Class Time (3rd Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Is there any additional information about this student you would like to share with us?

Swim Student 2

First Name
Birth Date (MM/DD/YYYY)
Gender Male Female
Program:
  Infant/Toddler
Pre-Schooler
Beginning
Intermediate/Adv
Young Adult
Adult
Preferred Class Time (1st Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Preferred Class Time (2nd Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Preferred Class Time (3rd Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Is there any additional information about this student you would like to share with us?

Swim Student 3

First Name
Birth Date (MM/DD/YYYY)
Gender Male Female
Program:
  Infant/Toddler
Pre-Schooler
Beginning
Intermediate/Adv
Young Adult
Adult
Preferred Class Time (1st Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Preferred Class Time (2nd Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Preferred Class Time (3rd Choice):
Sun M Tu W Th F S
  Morning Afternoon Evening
Is there any additional information about this student you would like to share with us?

 

Pre-Register