Registration
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Please complete the following registration form to request private or semi-private lessons through Hinsdale Swim School. All lessons are held at Westmont High School. Please allow 3–5 days for us to coordinate an instructor who best fits your swimmer’s needs and your family's schedule. You will receive an email with your assigned instructor, weekly day and time, and start date. Once you confirm your lesson schedule from that email, the lesson package will be billed to your card on file. Private lessons cannot be scheduled during our group lesson times. Packages cannot be purchased with the intent to be shared between swimmers. If registering through our Parent Portal, please “Add to Cart” to start your request and ensure you check out (at $0 cost) to submit your request. Note: The date listed on this page simply indicates how long the form will remain open for submissions. It is not related to your lesson request or registration.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email - REQUIRED FOR LIFEGUARDING (LIST EMAIL USED FOR PREVIOUS RED CROSS CERTIFICATIONS):
Swim Team(s) and Practice Group - REQUIRED FOR CLINICS:
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email - REQUIRED FOR LIFEGUARDING (LIST EMAIL USED FOR PREVIOUS RED CROSS CERTIFICATIONS):
Swim Team(s) and Practice Group - REQUIRED FOR CLINICS:
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email - REQUIRED FOR LIFEGUARDING (LIST EMAIL USED FOR PREVIOUS RED CROSS CERTIFICATIONS):
Swim Team(s) and Practice Group - REQUIRED FOR CLINICS:
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email - REQUIRED FOR LIFEGUARDING (LIST EMAIL USED FOR PREVIOUS RED CROSS CERTIFICATIONS):
Swim Team(s) and Practice Group - REQUIRED FOR CLINICS:
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email - REQUIRED FOR LIFEGUARDING (LIST EMAIL USED FOR PREVIOUS RED CROSS CERTIFICATIONS):
Swim Team(s) and Practice Group - REQUIRED FOR CLINICS:
Questions/Options:
Private or Semi-Private Lessons? Private Swim Lessons (1:1): individualized swim instruction Semi-Private Swim Lessons (2:1): two swimmers of similar ability, arranged by the client
*
Semi-Private Only: If the other semi-private participant is not part of your family, who is the other swimmer?
What is your preferred weekly day/time? Summer HSS Hours: Sundays: 8am-10am & 11am-12PM Monday: 2-5 PM & 6-7PM Tuesday: 2–4:30PM & 5:30–7PM Wednesday: 2-5 PM Thursday: 4–4:30PM & 5:30-6:00 PM
*
What size package did you want to purchase (see chart for pricing)? If registering more than one swimmer, this is the number of lessons for EACH swimmer. 4 Lesson Package 8 Lesson Package
*
What is your preferred Instructor Level (see chart for pricing)? Coach: 10 Years Experience Senior Instructor: 5 Years Experience Instructor: 1-4 Years Experience
*
If you have a specific Hinsdale Swim School Instructor you'd like to request, who is your preferred instructor?
What is your requested start date to begin lessons?
*
Let us know anything important about your swimmer (s)—goals, challenges, or preferences.
*
Additional Information:
Other Questions/Comments:
Credit Card Verification:
*
Add Credit Card
eCheck/Bank Draft:
Bank Name:
Bank Routing Number:
(9-digit number)
Your Account Name:
(Your name on your bank statement)
Your Account Type:
Checking
Savings
Account Number:
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