Book Your Swim Lessons Below! "*" indicates required fields Step 1 of 2 50% Name* First Last Email* Enter Email Confirm Email Phone*Text Message Opt-In* Yes - Opt-In To Receive Text Messages. If you don't want to continue receiving SMS please text the word "STOP" No - I Do Not Wish To Receive Text Messages. Do you allow us to send you messages regarding the status of your swim lessons, invoicing, and other communications?Where will lessons take place?* Pool Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Do you have access to a pool?* Participant's Names* Participant's Age's* Start Date* Does not have to be accurate, please input a rough estimate date/monthLesson Option*Enter Zip code FirstHow many students are taking lessons?*1 Student2 Students3 Students4 Students5 Students6 StudentsWhat is the students main goal?Have you, a family member, or participants showed any signs or symptoms of covid-19 in the past 10 days?* Yes No Does participants have any health related issues?* Yes No Preferred Days/Times? Instructor Preferences?MaleFemaleNo PreferenceIf you were referred to us, please list their namesHow did you hear about us?GoogleFacebookInstagramReferralOtherDo you understand that availability is not guaranteed? Please note the more flexible your schedule can be, the easier it will be to match you with an instructor?YesNoDo you understand that InstaSwim will send you an invoice via email after you confirm a start date with your instructor?*YesNoComments and ConcernsDo you understand that there is a one time $20 annual registration fee per student that is added onto your invoice for payment when matched?*By submitting your registration, you are agreeing to our 2023 policies & guidelines?* Yes I agree You can find our policies page located at the bottom of our website.