Lesson Termination Form

Wait! Before you Terminate, we would like to remind you of our OLYMPIC MEMBERSHIP BENEFITS which is obtained after one full year of continuous enrollment and includes: 5% Discount off all Perpetual Lessons, 10% Discount on Retail, 25% off Parties, and Free Family Open Swim!

Swimmer's Name(s) *

Parent's Name *

Email *

Phone Number *

What is the best way to reach you? *

What would be the best time to reach you? *

Example: Anytime after 2PM

Terminate lessons:

At end of this paid term

At end of 16 Lesson Minimum (Parent & Me)

Immediately (any unused credit in your account will be held until further notice from you, and can be used for lessons, retail, or birthday party at any future date)

Specific Date of Termination:

Single Line Text

Specific Date of Termination

Swim Instructors name(s) *

Describe if name unknown

Please Let Us Know The Reason You Are Terminating Lessons. Your Honesty Helps Us Continually Improve Our Program *

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Our staff will contact you within seven days to confirm the date of your last paid lesson.

Please remember that if you give notification by the 14th of the month, your monthly fee for the following month (Jan for Feb lessons) will not be debited on the 15th. However, if you give notice on or after the 15th of the month, your monthly fee will be debited. There will be NO REFUNDS. If you need to discontinue lessons, effective immediately, any charged balances will be kept in your Academy Swim Club account. This credit may be applied to future lessons, retail products, parties or any other service. (Parent & Me credit must be applied to lessons until the 16 lesson minimum commitment is met, then it can be applied to any service or product we offer). Challenges to credit cards or banks to refund charges will incur a $50 special handling fee. Early withdrawals will incur a $125 early termination fee per child.

Available make up lessons will expire on the date of your last scheduled lesson. Please complete all make up lessons before your last lesson to avoid losing them.