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YMCA OF METRO NORTH
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Demakes Family YMCA | Lynn
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Torigian Family YMCA | Peabody
YMCA of Metro North Gymnastics Center
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Private Swim Lessons Request Form
Private Swim Lesson Request Form
Primary Member/ Parent Name
*
First
Last
Are you a YMCA of Metro North Member?
*
Yes
No
At which Branch would you like private lessons?
*
Torigian Family YMCA (Peabody)
Demakes Family YMCA (Lynn)
Melrose Family YMCA
Saugus Family YMCA (Summer Only)
Primary Member/Parent Phone Number
*
Primary Member/Parent Email
*
Select the Lesson Package you are interested in
*
Private Lesson - 1 Lesson
Private Lesson - 4 Lessons
Private Lesson - 6 Lessons
Semi-private Lessons - 1 Lesson
Semi-private Lessons - 4 Lessons
Semi-private Lessons - 6 Lessons
(Private Lessons: 1 individual)
(Semi-private Lessons: 2-3 individuals)
Instructor Preference
*
Male
Female
No Preference
Days Available
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Times Available
*
What age is the participant?
Preschool (ages 3-6)
Youth (ages 6+)
Adult (ages 17+)
Please list any goals you'd like to achieve during private lessons.
Please list/explain any limitations or disabilities that will help us customize your program.
Additional Comments