Lifeguard Training Course #2

First Name*

Last Name*

Email Address*

Phone Number*

Birthdate*

Home Address (Include City, State, and Zip)*

What level swimmer are you?*
Beginner - I need swimming lessons.Intermediate - I know how to keep myself afloat and swim the full length of the pool.Advanced - I can tread water and swim multiple laps in the pool.

Emergency Contact (Name, Relationship, Phone)*

How did you hear about us? If referred by a person, put their full name here. *