Class Enrollment Registration Form

Three Easy Steps

Submit
Enrollment Form

Submit Payment

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Tell a Friend

Classes are scheduled at a host pool. When a pool host has a class set up they will be given a code that will allow their friends to sign up online for that class YOU DO NOT NEED A POOL OR A CODE TO TAKE A CLASS. When you sign up for a class you will choose a time frame priority from a list from first to last preference. You will give your address as well. I will then call you when a class is available in your area and matches your chosen time frames. I will call the parents in the order that they signed up and enrolled for class.

If you have a pool at home, please consider hosting a class.

You will not only help other parents and their children be safer but you will have your child learning in the best environment and in the most convenient circumstances available, at home

If you encounter any problems, simply call me at:
(714) 388-2330.

Thank you.

Please fill all required fields


Contact Name: *
Email Address: *
Home Phone: *
Cell Phone:
Address: *
Address (optional):
City: *
State: *
Zip Code Area: *

Student #1 Name: *
Birth Date: *	Calendar
Student #2 Name:
Birth Date:	Calendar
Student #3 Name:
Birth Date:	Calendar
Student #4 Name:
Birth Date:	Calendar

Invitation Code:
Time Priority #1: *
Time Priority #2: *
Time Priority #3: *
Do you own a private residential pool?
If YES, would you consider pool hosting?

Total number of guests enrolled:

Cost of enrollment:
Down payment amount for enrollment:

Class Enrollment Registration Form

Three Easy Steps

Submit Enrollment Form

Submit Payment

Now, Tell a Friend

Submit
Enrollment Form

Now,
Tell a Friend