Thank you for choosing Watch Me Swim, LLC, Tampa Bay's leading provider of self-rescue swim lessons. Your Instructor is ANGELICA NAVARRO. All information is confidential and will never be shared with a 3rd party.

AVAILABILITY: Please email angelica@watchmeswim.com for availability information before completing this form.

HIGH 5, Inc: May: Availability from 8:00 a.m. - 10:00 a.m.

June - July: Availability from 7:00 a.m. - 9:00 a.m.

August - October: Availability from 7:00 a.m. - 10:00 a.m.

WMS REGISTRATION FEE: $90 paid one-time per new student. Nonrefundable.

$25 paid annually for each returning student after the 1st year.

All registration fees must be paid online to Watch Me Swim, LLC.

WEEKLY TUITION: $80 per child, per week.

Paid directly to Angelica Navarro via cash or check at poolside.

BEFORE YOU BEGIN: Due to the high volume of families served each year and in order to better streamline the scheduling process, payment of the WMS Registration Fee is required at the time of submitting this form. Lessons are reserved on a first come first serve basis. If the WMS registration fee is not received at time of submitting this form, your requested start date and lesson time will be given to the next paid student. Early registration is highly recommended to avoid being put on a waiting list.

Student's Last Name *

Student's First Name *

Age in months/yrs: *

Date Of Birth:
Must be atleast 6 months of age. * +

Gender *

Choose Skill Level That Fits Best *

Please Describe All Previous In Water Experience * 🛈

0/500 characters

Does this child attend daycare/preschool either full time or part time? *

Yes

No

Name of Preschool/Daycare:

Scheduling Requests/Comment?

Name of Student's Pediatrician or Primary Health Care Physician *

Has This Student Ever Been Seen By A Medical Specialist Other Than His Pediatrician? *

Yes

No

If Yes, Please Explain & Include Date of Last Visit

0/500 characters

Does this student have any health issues or concerns such as allergies, current medications, therapy, history of seizures, etc. *

Yes

No

If Yes, Please Explain

0/500 characters

Will You Be Registering A 2nd Student? *

Yes

No