Swim Questionnaire

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Swim Questionnaire

Swimmer Questionnaire

Parent's First Name:

Parent's Last Name

Swimmer's First Name

Swimmer's Last Name

Email:

Phone:

Swimmer's Age:

What skills is your swimmer proficient in?

Putting their entire head underwater

Floating on their stomach

Floating on their back

Freestyle Kick on a board

Streamline with Freestyle Kick

Freestyle Strokes

Freestyle Side Breathing

Backstroke Kick

Backstroke Arms

Breaststroke Kick

Breaststroke Arms

Butterfly Kick

Butterfly Arms

Treading Water

25 meter lengths of all 4 Competitive Strokes

50 meter lengths of all 4 Competitive Strokes

Freestyle Flip Turn

Backstroke Flip Turn

Breaststroke & Butterfly Touch-and-Go Turn

IM Turns

Racing Start

Thank you for completing the Swim Level Questionnaire.

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Questions? Contact us!

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Contact Information

Email: qoswim@ccacc-dc.org

Phone: 301-948-3116

Address: 16601 Roundabout Drive, Gaithersburg, MD, 20878, United States

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