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Pre-Registration: Private and Semi-Private Swimming Lessons

Thank you for your interest in private or semi-private lessons with the Perth & District Indoor Pool. Please complete the form below in full so that we can be accommodate the Participant's needs and ensure their success.

Your First and Last Name

Phone Number

Email Address

First and Last Name of Participant

Age of Participant

Does the Participant have any medical conditions?

Yes

Does the Participant have a physical disability or limited mobility?

Yes

Does the Participant communicate verbally?

Yes

Please describe the participant's swimming ability

Does the Participant require a life-jacket?

Yes

Does the Participant require guidance?

Yes

Can the Participant swim independently?

Yes

Does the Participant have any sensory needs or challenges?

Yes

How do you know when the Participant is upset or agitated?

What upsets or agitates them?

How do you redirect the Participant when they're upset or agitated?

What is the best way to direct them?

How does the Participant best understand instructions (verbally, visually, etc.)?

What things or hobbies does the Participant enjoy?

Are their certain behaviours that we should be aware of?

Yes

If there's anything else that we should be aware of, please let us know

Forms

Pre-Registration: Private and Semi-Private Swimming Lessons