Swim Team Lessons – Peachwood Swim Club

2026 Swim Team Lesson Sign Ups

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Parent/Guardian Information

Parent or Guardian Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Child's Information

Child's Name*

First Last

Swim Team Age Group*

Swim Lesson Selection

Select Your Week First*

Select Your Day Next*

Select Your Time Monday, June 22nd*

Select Your Time Tuesday, June 23rd*

Select Your Time Wednesday, June 24th*

Select Your Time Thursday, June 25th*

Select Your Time Monday, June 29th*

Select Your Time Tuesday, June 30th*

Select Your Time Wednesday, July 1st*

Select Your Time Thursday, July 2nd*

Select Your Time Monday, July 6th*

Select Your Time Tuesday, July 7th*

Select Your Time Wednesday, July 8th*

Select Your Time Thursday, July 9th*

Select Your Time Monday, July 13th*

Select Your Time Tuesday, July 14th*

Select Your Time Wednesday, July 15th*

Select Your Time Thursday, July 16th*

Select Your Time Monday, July 20th*

Select Your Time Tuesday, July 21st*

Select Your Time Wednesday, July 22nd*

Select Your Time Thursday, July 23th*

Select Your Time Monday, July 27th*

Select Your Time Tuesday, July 28th*

Select Your Time Wednesday, July 29th*

Select Your Time Thursday, July 30th*

Additional Information/Waiver

What do you want the coach to work on with your swimmer at this lesson? (We will do our best to accommodate your choice)

Liability Waiver*

By registering my child(ren) with the Peachwood Recreational Swim Club, I agree to participate (or allow my
child(ren) and family members to participate) in the Peachwood Swim Lessons, and hereby release Peachwood Recreational Swim Club, their officers, directors, employees, and agents, its directors, officers, agents, coaches, and employees from liability for any injury that might occur to myself (or to my child(ren) and family members) while participating in the Peachwood Swim Lessons program, including travel to and from training sessions, swim meets or other scheduled team activities.

I agree to indemnify and hold harmless the above mentioned organizations and/or individuals, their agents and/or employees, against any and all liability for personal injury, including injuries resulting in death to me, my child(ren) and/or other family members, or damage to my property, the property to my child(ren) and/or other family members, or both, while I (or my child(ren) or family members) participating in the Peachwood Swim Lessons program.

I agree to the Terms of Service

You must scroll through the entire waiver in order to check your consent.

Payment

Please be sure to only hit the "submit" button once.

Payment Type*

Credit Card

ACH

If you would like to purchase multiple slots we suggest using ACH. It seems that our payment processor right now is limiting one purchased slot per credit card. (6-11 Update)

Swim Team Lesson Fee*

Price:

Total

Credit Card*

American Express

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MasterCard

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Card Number

Expiration Date

Security Code Cardholder Name

ACH*

Account Number Account Type Routing Number Account Holder Name

Order Token