PRE-REGISTER NOW MERRITT ISLAND SWIM SCHOOL PRE-REGISTRATION Thank you for pre-registering for lessons at Merritt Island Swim School. Please discuss any questions or concerns with your instructor prior to registration. Please submit one form per student. REGISTRATION FEE for NEW STUDENTS: $50, RETURNING STUDENTS: $25 LESSON FEES: $80 PER WEEEK/PER CHILD via cash or add $5 fee for payments made via check or PayPal Lessons are 4 days per week, Monday through Thursday for approximately 10-15 minutes per lesson depending on age and endurance. Lessons end on a performance-based exit instead of a time-based exit, meaning we end the lesson on the student's best performance of the skill we are working on that day, before becoming physically fatigued. DISCOUNTS: $10 per week for siblings in lessons at the same time, active duty Military, Law Enforcement and First Responder families. Registration and First Week Lesson Fee is due upon registration approval and is non-refundable. The payment link will be sent to your e-mail once your registration has been approved and scheduling availability has been confirmed.RM_StatsUsername *Password *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long.Email *PRIMARY CONTACTPARENT FIRST NAME *PARENT LAST NAME *RELATIONSHIP TO STUDENTSelect an optionMOTHERFATHERGRANDPARENTGUARDIANSELFMOBILE NUMBER *MOBILE PHONEALTERNATE PHONESTREET ADDRESS State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming SECONDARY CONTACTFIRST NAME *LAST NAMERELATIONSHIP TO STUDENTSelect an optionMOTHERFATHERGRANDPARENTGUARDIANOTHERMOBILE NUMBERSTUDENT INFORMATIONNEW OR RETURNING? NEW STUDENT RETURNING STUDENT STUDENT FIRST NAME *STUDENT LAST NAME *GENDER MALE FEMALE DATE OF BIRTH *WATER EXPERIENCEMEDICAL HISTORYMEDICATIONSCOMMENTSSCHEDULING REQUESTREQUESTED LESSON TIMEREQUESTED START DATEHOW DID YOU FIND US?PRE-REGISTRATION FORM Please add me to your mailing list for news and special offers. Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
