Withdrawal Request Form

Recurring lessons have a minimum commitment of 8 weeks of lessons. You can stay on the schedule as long as you’d like, but we require notification of intent to withdraw via this form by the 5th of the current month in order to end lessons by the final calendar day of the current month. Requests made after this date will be eligible to withdraw after the following month.

Guardian Name

First Name

Last Name

Phone

(###)

###

####

Swimmer name(s) that you would like to withdraw from lessons

Current Instruction Day

Monday

Tuesday

Wednesday

Thursday

Friday

Open to whatever you have open

I understand that recurring lessons have a minimum commitment of 8 weeks of lessons. After this, I must withdraw by the 5th of the month to be released from lessons by the end of the current month. If it is past the 5th, my lessons will continue through next month, and then billing will end.

Yes

We love your feedback - please provide us some insight on your session, why you are withdrawing and what we can do to make it an even better experience going forward. Thank you for swimming with us.