Inclusive Swim Lesson Form

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The Inclusive Swim Lesson program features 1-on-1 instruction for individuals with a diagnosed disability.  Special attention is given to each participant’s cognitive and motor skills.  Strokes are modified to meet participants' capabilities and goals for independent swimming and safety.  The Inclusive Swim Lesson program is partially subsidies by a Scholarship Fund through the Clayton Century Foundation (CCF).

Participants must complete a Recreation Assessment prior to scheduling lessons.  Please contact Mallory Smysor CTRS, Coordinator of Inclusion Services at 314-290-8507 or msmysor@claytonmo.gov to schedule a Recreation Assessment.  An updated Recreation Assessment is required every year to continue with the Inclusive Swim lesson program.

Please correct the field(s) marked in red below:

Step 1: Registration Information 

Registration Type
 *
Registration Type
Participant and Contact Information
 *
Participant and Contact Information

Step 2: Lesson Packages 

Participants will be contacted for payment information.

Private Swim Lessons
Private Swim Lessons

Step 3: Scheduling Preferences

Please select the your available start times from the options below.

9:00 am - 11:30 am
9:00 am - 11:30 am
11:30 am - 4:00 pm
11:30 am - 4:00 pm
4:00 pm - 7:30 am
4:00 pm - 7:30 am
RENEWAL REGISTRATION: If continuing currently ongoing lessons, please provide the following:
RENEWAL REGISTRATION: If continuing currently ongoing lessons, please provide the following:

Step 4: Policy Agreement 

CANCELLATION POLICY: Lessons will be conducted as scheduled. The City of Clayton may substitute instructors without notice. Once lessons have been scheduled, cancellations must be made at least 24 hours in advance. Lessons cancelled with 24 hours’ advance notice will be rescheduled based on instructor availability. Lessons cancelled for any reason without 24 hours’ notice will not be rescheduled. Clients are permitted one reschedule date within a 4-lesson package, two reschedule dates with a 8-lesson package, and three reschedule dates within a 12-lesson package. To cancel or reschedule a private lesson, please contact 314-290-8556 or by email at privateswimlessons@claytonmo.gov.

WAIVER OF LIABILITY: My family and I hereby waive and release the City of Clayton, The Center of Clayton, the School District of Clayton, the Clayton Recreation Sports & Wellness Commission, and their representatives from claims and damages and/or injuries incurred while participating in or as a spectator at a sponsored activity. I also agree, as a participant or parent of a minor participant, to grant full permission to the City of Clayton to use my name, photograph, video-tape, or recordings for any publicity promotion purposes without obligation or liability to me or my family.

Agreement to policies
 *
Agreement to policies
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