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Building Confident Swimmers. Saving Lives.

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FREE WATER TEST

Is your CHILD Water Safe?

Two-step guide below

Many parents believe their child is safe in the water until they see their real skill level. Complete this form to determine If your child qualifies for a FREE skills or Water Safety Assessment

Child's Age

6 months - 2 years & 11 months 3+ 6+

If other children, please Specify Ages:

Which best describes your child in the water?

Has never taken swim lessons Has experience but cannot swim independently Needs stroke development

Additional Information of other Children If Applicable/CS NOTES

Does your child have regular access to any nearby bodies of Water?

Yes No

If your child accidentally fell into a pool today, would they know what to do?

Yes No

What made you start looking for swim Programs now?

Water safety & Drowning Prevention I've tried other places and need to See Results in my child's Swim Journey I want continued Skill Development / Stroke Improvement

How soon would you like your child to learn to swim ?

In the next few months No rush As Soon As Possible

Which Location would you be willing to attend to take our Free In person Assessments?

Coral Springs Margate Parkland

Full Name

Phone

Email