Review Your Lesson Order

Host Client Name:
Host Pool Address:
Zip Code:
Metro Area:
Major Cross Streets: /
Home Phone:
Cell Phone:
Are you a returning customer:
New Clients, Terms?

Booking Info
Pool Party Date:
Number of swimmers expected:
Age Range of Pool Guests:
About How many Pool Guests age 3 years or under?:
About How many Pool Guests age 4-9 years?:
Number of Lifeguards Desired:
Choose start: :
Choose end: :
Parent Notes for our Office:
Price: $.00

Payment details

Pay by credit card | Pay by check

If you need to pay by purchase order or check, this can be done. Email for instructions.

Secured by 256bit SSL Cert

pay now $.00 back to the form