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Private Swim Lesson Participant Information Form

  1. JCPRD logo

  2. Thank you for you interest in Private Swim lessons at the Shawnee Mission School District Aquatic Center. To get started with this program, a participant information form must be filled out. This information is used to help match the participant with an instructor and also give the instructor a bit of the participant's history and goals. Once participant information form is submitted it will be reviewed and an instructor will contact you. This program is a first come, first serve program and there may be a waiting list.

  3. Participant Information:

  4. Gender*

  5. Parent/Guardian Information

    (required if participant is < 18 years old)

  6. Please Read through the following policies and procedures for Private Lesson Program

    1. Payment must be received by the front desk of the Shawnee Mission School District Aquatic Center before the start of the first lesson. The front desk attendant will give you a receipt to show the instructor. All payments must go through JCPRD, do not pay instructor directly.

    2. All classes must be conducted at the Shawnee Mission School District Aquatic Center.

    3. Please sign in at front desk when arriving at facility for lesson.

    4. It is important for participants to be on deck and ready to go at least five minutes before their lesson begins. Participants should use the restroom before class begins. The instructor will inform parents and participants where to meet each day.

    5. Participants will need to wait on pool deck, not in the water, until the instructor is ready to begin the lesson.

    6. During the lesson, parents may be asked to wait in the main lobby or remain on the pool deck. This is up to the instructor and they will tell you their preference the first lesson.

    7. Please do not interfere with the instructor or child during lesson.

    8. 24 HOUR CANCELLATION POLICY: 24-hour notice is required when canceling or re-scheduling a lesson. Should you cancel your lesson within the 24-hour period of the lesson, you will be charged for the lesson.

    9. If participant is a no-show for a lesson, participant will be charged for that lesson.

    10. There are no refunds for private lessons.

    11. Swim lessons sessions purchased are good for 6-month period. After six months the lessons are not valid and must purchase a new session.

    12. Scheduling of lessons will be conducted between the participant and the instructor. After returning this information and instructors are available, you will receive contact from your instructor to schedule lesson dates and times.

    13. If participant is not a member of the Shawnee Mission School District Aquatic Center, participant is allowed access to the facility for their lesson time only.

    14. If after your 4-lesson session you wish to continue doing lessons, you may do so by scheduling lessons with instructor and paying for another session at the front desk. Participant does not need to fill out a new form. If there is a long break in between lesson sessions, participant may be required to re-submit information.

  7. Agreement to Private Swim Lessons Policies and Procedures*

  8. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  9. Leave This Blank:

  10. This field is not part of the form submission.