Participant's Name: *
Birth Date: *
Parent/Guardian's Name: *
Parent/Guardian's Email: *
Parent/Guardian's Phone/Text: *
*Please note that you will be contacted by text with the instructors contact information.
Please select the level that most closely matches the skill requirements of your child.
Level 1-Introduction to Water SkillsLevel 2-Fundamental Aquatic SkillsLevel 3-Stroke DevelopmentLevel 4-Stroke Improvement
Please select preferred day/days and lesson time/times (the following are offered to avoid peak crowds).
Early MorningLate MorningEvening
Early MorningLate Morning
Preferred Instructor: *
Cost is $25 per ½ hour session for private and $20 per person per ½ hour session for 2 or more children. Non-member lessons are $35 per ½ hour session and $30 per person per ½ hour session for 2 or more children. Please make checks payable to: Southern Village Club. PAYMENT IS DUE UPON COMPLETION OF EACH LESSON.
I hereby assume all risks relating to or arising from swimming lessons at Southern Village Club. I release and absolve, Southern Village Club, its managers, owners, agents, employees, volunteers, and sponsors from all liability associated with the activity and in the event of injury, do expressly waive all claims against them.
Southern Village Club maintains a 24 hour cancellation policy. Cancellations made within this time frame or no-shows will be charged the full amount of the lesson. Unexpected illness is understood, but reasonable notice must be provided to avoid being charged.
* By checking this box and typing my name below, I am electronically signing my application.
Participant/Parent's Signature (Type your name): *
* Required Information
For more information, please contact the Club Manager at:
601 Brookgreen Drive
Chapel Hill, NC 27516