337 West 14 Streets #62, New York, NY 10014
Tel 212-206-6976   / C-917-291-2561 / E: AGAquaskills@hotmail.com


Applicants Name       Age  
Address       Zip Code  
E-Mail
Home Telephone   Cell Phone    Work Telephone  
Schedule One       Time    
Schedule Two       Time    
Pool Location your pool     my pool
Pool Name & Location
( if selected "my pool")
Start Date
Course Description
Water Aerobics
Waist Size      Glove Size       Foot Size 
Private (one to one)        Group (how many) 
Package   how many  
Form of Payment
Objective
Today Date
 


Policy:

$100.00 registration fee required to secure time for 1st meeting

Payment for enrollment must be paid in full before the first session, in the form of a check made payable to AGAquaSkills.  Cash, Credit Card or Paypal.

Once the payment is made and the student decides not to continue the lesson due to their own conflict in schedule there is a one week follow up period from that day onward where the student can reschedule.  Schedule must be agreed to by instructor and student.

Applicants discontinuance of class is non-refundable
  
 Please have your credit card information ready before submitting