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WELCOME TO

THE BOROUGH OF COUDERSPORT

Swimming Lessons Sign Up

Please use the form to your right to sign up for our swimming lessons. We have a few sessions to choose from and we will post on here how many slots are left as we begin filling them up:

SESSION 1: June 16 – June 20 (Full Availability)

SESSION 2: June 23 – June 27 (Full Availability)

SESSION 3: June 30 – July 04 (Full Availability)

SESSION 4: July 07 – July 11 (Full Availability)

SESSION 5: July 14 – July 18 (Full Availability)

EVENING SWIM LESSON: July 21 – July 25 6pm – 7pm (Full Availability))

PARENT / CHILD: July 28 – August 01 (Full Availability)

Swimming Lessons Sign Up

PARENT / GUARDIAN INFORMATION

Please do not complete this form for someone elses child.

First Name *

Last Name *

Phone

How many children will you be signing up? *

More than 3

Please do not complete this form and give us a call

CHILD 1 INFORMATION

Relationship *

Relationship

Child Name *

Phone

Age *

What level is this child? *

1, 2 or 3

4, 5, 6 or 7

Please choose 2 sessions from the list below *

Session 1 - June 16 - June 20

Session 2 - June 23 - June 27

Session 3 - June 30 - July 4

Session 4 - July 7 - July 11

Session 5 - July 14 - July 18

Evening Swim - July 21 - July 25 6p - 7p

Parent / Child - July 28 - August 1

From your choices, we will place you in the first available slot

Any Additional Information that will help us select the proper session

CHILD 2 INFORMATION

Relationship *

Relationship

Child Name *

Phone

Age *

What level is this child? *

1, 2 or 3

4, 5, 6 or 7

Please choose 2 sessions from the list below *

Session 1 - June 16 - June 20

Session 2 - June 23 - June 27

Session 3 - June 30 - July 4

Session 4 - July 7 - July 11

Session 5 - July 14 - July 18

Evening Swim - July 21 - July 25 6p - 7p

Parent / Child - July 28 - August 1

From your choices, we will place you in the first available slot

Any Additional Information that will help us select the proper session

CHILD 3 INFORMATION

Relationship *

Relationship

Child Name *

Phone

Age *

What level is this child? *

1, 2 or 3

4, 5, 6 or 7

Please choose 2 sessions from the list below *

Session 1 - June 16 - June 20

Session 2 - June 23 - June 27

Session 3 - June 30 - July 4

Session 4 - July 7 - July 11

Session 5 - July 14 - July 18

Evening Swim - July 21 - July 25 6p - 7p

Parent / Child - July 28 - August 1

From your choices, we will place you in the first available slot

Any Additional Information that will help us select the proper session

Signature

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Borough of Coudersport

201 S. West Street
Coudersport, PA 16915
Phone: 814-274-9776
Fax: 814-274-0611