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Select
Never had lessons before
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Starfish (Parent & Tot)
Duck (Parent & Tot)
Sea Turtle (Parent & Tot)
Sea Turtle (Preschool)
Sea Otter (Preschool)
Salamander (Preschool)
Swim Kids 1
Swim Kids 2
Swim Kids 3
Swim Kids 4
Swim Kids 5
Swim Kids 6
Swim Kids 7
Swim Kids 8
Swim Kids 9
Swim Kids 10
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Sunday
Water Safety Instructor Part 1A
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National Lifeguard
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MM
DD
YYYY
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Never had lessons before
Other (Explained in Special Notes)
Starfish (Parent & Tot)
Duck (Parent & Tot)
Sea Turtle (Parent & Tot)
Sea Turtle (Preschool)
Sea Otter (Preschool)
Salamander (Preschool)
Swim Kids 1
Swim Kids 2
Swim Kids 3
Swim Kids 4
Swim Kids 5
Swim Kids 6
Swim Kids 7
Swim Kids 8
Swim Kids 9
Swim Kids 10
Rookie (Swim Patrol)
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Star (Swim Patrol)
Bronze Star
Bronze Medallion
Bronze Cross
Stroke Improvement
Adult
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Choose a day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Water Safety Instructor Part 1A
Water Safety Instructor Part 1B
Water Safety Instructor Part 2
National Lifeguard
Stranger Danger
Home Alone
Babysitting
Adult CPR
Standard First Aid
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5:15pm (45min)
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Wednesday Time
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Child #3 Name
*
First
Last
Birthday
*
MM
DD
YYYY
Current Swim Level
*
Select
Never had lessons before
Other (Explained in Special Notes)
Starfish (Parent & Tot)
Duck (Parent & Tot)
Sea Turtle (Parent & Tot)
Sea Turtle (Preschool)
Sea Otter (Preschool)
Salamander (Preschool)
Swim Kids 1
Swim Kids 2
Swim Kids 3
Swim Kids 4
Swim Kids 5
Swim Kids 6
Swim Kids 7
Swim Kids 8
Swim Kids 9
Swim Kids 10
Rookie (Swim Patrol)
Ranger (Swim Patrol)
Star (Swim Patrol)
Bronze Star
Bronze Medallion
Bronze Cross
Stroke Improvement
Adult
Child #3 First Choice
*
Choose a day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Water Safety Instructor Part 1A
Water Safety Instructor Part 1B
Water Safety Instructor Part 2
National Lifeguard
Stranger Danger
Home Alone
Babysitting
Adult CPR
Standard First Aid
Monday Time
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10:00am (30min)
10:30am (30min)
11:00am (30min)
11:30am (30min)
1:00pm (30min)
1:30pm (30min)
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5:45pm (45min)
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Wednesday Time
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6:00pm (45min)
6:45pm (45min)
7:00pm (Bronze 2hrs)
Thursday Time
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Saturday Time
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5:15pm (45min)
Sunday Time
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Child #3 Second Choice
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Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Monday Time
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11:00am (30min)
11:30am (30min)
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5:45pm (45min)
6:30pm (45min)
Wednesday Time
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6:00pm (45min)
6:45pm (45min)
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Thursday Time
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11:00am (30min)
11:30am (30min)
1:00pm (30min)
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2:00pm (30min)
2:30pm (30min)
4:00pm (45min)
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6:15pm (45min)
Saturday Time
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11:30am (45min)
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5:15pm (45min)
Sunday Time
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Child #3 Third Choice
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Monday Time
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Wednesday Time
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11:00am (30min)
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Saturday Time
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Sunday Time
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12:15pm (45min)
Child #4 Name
*
First
Last
Birthday
*
MM
DD
YYYY
Current Swim Level
*
Select
Never had lessons before
Other (Explained in Special Notes)
Starfish (Parent & Tot)
Duck (Parent & Tot)
Sea Turtle (Parent & Tot)
Sea Turtle (Preschool)
Sea Otter (Preschool)
Salamander (Preschool)
Swim Kids 1
Swim Kids 2
Swim Kids 3
Swim Kids 4
Swim Kids 5
Swim Kids 6
Swim Kids 7
Swim Kids 8
Swim Kids 9
Swim Kids 10
Rookie (Swim Patrol)
Ranger (Swim Patrol)
Star (Swim Patrol)
Bronze Star
Bronze Medallion
Bronze Cross
Stroke Improvement
Adult
Child #4 First Choice
*
Choose a day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Water Safety Instructor Part 1A
Water Safety Instructor Part 1B
Water Safety Instructor Part 2
National Lifeguard
Stranger Danger
Home Alone
Babysitting
Adult CPR
Standard First Aid
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10:30am (30min)
11:00am (30min)
11:30am (30min)
1:00pm (30min)
1:30pm (30min)
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6:30pm (45min)
Wednesday Time
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7:00pm (Bronze 2hrs)
Thursday Time
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Saturday Time
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5:15pm (45min)
Sunday Time
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10:45am (45min)
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Child #4 Second Choice
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Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Monday Time
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10:30am (30min)
11:00am (30min)
11:30am (30min)
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1:30pm (30min)
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2:30pm (30min)
4:15pm (45min)
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5:45pm (45min)
6:30pm (45min)
Wednesday Time
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6:00pm (45min)
6:45pm (45min)
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Thursday Time
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11:00am (30min)
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Saturday Time
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5:15pm (45min)
Sunday Time
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10:45am (45min)
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Saturday
Sunday
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Wednesday Time
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Sunday Time
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First Choice
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Water Safety Instructor Part 1A
Water Safety Instructor Part 1B
Water Safety Instructor Part 2
National Lifeguard
Stranger Danger
Home Alone
Babysitting
Adult CPR
Standard First Aid
Monday Time
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Wednesday Time
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Saturday Time
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10:00am (45min)
10:45am (45min)
11:30am (45min)
12:15pm (45min)
3:00pm (45min)
3:45pm (45min)
4:30pm (45min)
5:15pm (45min)
Sunday Time
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10:00am (45min)
10:45am (45min)
11:30am (45min)
12:15pm (45min)
Second Choice
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Monday
Tuesday
Wednesday
Thursday
Friday
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Sunday
Monday Time
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10:00am (30min)
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11:00am (30min)
11:30am (30min)
1:00pm (30min)
1:30pm (30min)
2:00pm (30min)
2:30pm (30min)
4:15pm (45min)
5:00pm (45min)
5:45pm (45min)
6:30pm (45min)
Wednesday Time
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4:30pm (45min)
5:15pm (45min)
6:00pm (45min)
6:45pm (45min)
7:00pm (Bronze 2hrs)
Thursday Time
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10:00am (30min)
10:30am (30min)
11:00am (30min)
11:30am (30min)
1:00pm (30min)
1:30pm (30min)
2:00pm (30min)
2:30pm (30min)
4:00pm (45min)
4:45pm (45min)
5:30pm (45min)
6:15pm (45min)
Saturday Time
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10:00am (45min)
10:45am (45min)
11:30am (45min)
12:15pm (45min)
3:00pm (45min)
3:45pm (45min)
4:30pm (45min)
5:15pm (45min)
Sunday Time
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10:00am (45min)
10:45am (45min)
11:30am (45min)
12:15pm (45min)
Third Choice
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Monday
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Wednesday
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Monday Time
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10:00am (30min)
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11:00am (30min)
11:30am (30min)
1:00pm (30min)
1:30pm (30min)
2:00pm (30min)
2:30pm (30min)
4:15pm (45min)
5:00pm (45min)
5:45pm (45min)
6:30pm (45min)
Wednesday Time
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4:30pm (45min)
5:15pm (45min)
6:00pm (45min)
6:45pm (45min)
7:00pm (Bronze 2hrs)
Thursday Time
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10:00am (30min)
10:30am (30min)
11:00am (30min)
11:30am (30min)
1:00pm (30min)
1:30pm (30min)
2:00pm (30min)
2:30pm (30min)
4:00pm (45min)
4:45pm (45min)
5:30pm (45min)
6:15pm (45min)
Saturday Time
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10:00am (45min)
10:45am (45min)
11:30am (45min)
12:15pm (45min)
3:00pm (45min)
3:45pm (45min)
4:30pm (45min)
5:15pm (45min)
Sunday Time
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10:00am (45min)
10:45am (45min)
11:30am (45min)
12:15pm (45min)
Notes:
Payment Option
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Cheque
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Please Send The Cheque to this Address
1755 Pickering Parkway
Pickering, Ontario
L1V 6K5
Phone: 905 683 9099
email:
pickering@swim-time.com
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