Marlon's Swimming Lessons - Learn to Swim and Save Lives
Customer Information Form


Please fill out the form below to be added to our customer list.


First Name
Last Name
Company
Email
Phone Number
Address
City
State
Zipcode
Comments
Services Requested
Private Swim Lessons
CPR/First Aid Training
Lifeguarding Training
Pool management
Swimming Pool Maintenance
Aquatics Consultant
Age Group
Infant
Child
Adult
Swimming Level
Non-Swimmer
Beginner
Intermediate
Advanced
Athlete (Triathlete/Master Swimmer)
Prefered Starting Date
Availability: Starting Time
Hours
 
 : 
Minutes
 
Availability: Ending Time
Hours
 
 : 
Minutes
 
Swimming Pool's Availability
Have Access To a Swimming Pool
Do Not Have Access to a Swimming Pool
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