Thank you for choosing Watch Me Swim. You are registering for lessons with Jennifer Stinson. All information is strictly confidential and will never be shared with another party.

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 first week's lesson fee and registration fee (if applicable) is required in advance. Lessons are reserved on a first come first serve basis. If payment is not received within 3 days of submitting this form, your requested date and time will be given to the next paid student. Early registration is highly recommended to avoid being put on a waiting list. For additional payment information please visit: http://watchmeswim.com/tuition.html

Location: Private Facility, 2914 Clubhouse Drive, Plant City, 33566

The pool is heated with water temperature remaining between 86-88 degrees.

General Availability: March 30: 10:00 a.m. - 12:40 p.m. and 2:40 p.m. - 6:50 p.m.

April - Sept.: 8:00 a.m. - 12:40 p.m. and 2:40 p.m. - 6:50 p.m.

Sept. - Oct: 7:00 a.m. - 12:40 p.m. and 2:40 p.m. - 6:50 p.m.

Oct. - Nov.: 8:00 a.m. - 12:40 p.m. and 2:40 p.m. - 5:30 p.m.

Student One Information

Student's Last Name *

Student's First Name *

Age in months: *

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

Gender *

Choose Level That Fits Best *

Please Describe All Previous In Water Experience * 🛈

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Start Date and Lesson Time

General Availability
March 30: 10:00 a.m. - 12:40 p.m. and 2:40 p.m. - 6:50 p.m.
April - Sept.: 7:30 a.m. - 12:40 p.m. and 2:40 p.m. - 6:50 p.m.
Sept. - Oct: 7:30 a.m. - 12:40 p.m. and 2:40 p.m. - 6:50 p.m.
Oct. - Nov.: 8:00 a.m. - 12:40 p.m. and 2:40 p.m. - 5:30 p.m.

Click on the calendar to choose your preferred start date. All lessons start on a Monday. * +

Choose your preferred lesson time using a 10 minute interval. Example: 11:10, 11:20, 11:30, 11:40, etc.
Lesson times must be conducive for Monday - Thurday. Different times for different days are not available. *

Scheduling Comment?

Student One Health Information

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

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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

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Will You Be Registering A 2nd Student? *

Yes

No