Before We Begin

A few details before your complimentary virtual intake, so we arrive knowing your swimmer and ready to map the journey ahead. Takes about five minutes.

Your Information Parent/Guardian, or Adult Swimmer

First name *

Last name *

Email *

Phone *

Preferred way to reach you

Text Email Call

The Swimmer You, or Your Child

Swimmer's name * (write "myself" if this is for you)

Age *

Current comfort level

No experience Beginner Developing Confident

Any prior lessons or swim experience?

In the Water How does your swimmer feel about the water right now? Any specific fears or moments that bring on nerves?

Face in water Deep end Jumping in Floating on back Separation

Anything else about their relationship with water we should know?

Goals & Temperament Mind · Body · Breath What would make this journey a success for you and your swimmer? When your swimmer feels nervous or challenged, what does it usually look like, and what helps them settle?

Health & Safety Medical conditions, allergies, or medications Sensory needs or anything affecting comfort in water or sun

Emergency contact name

Emergency contact phone

Your Journey Preferred days and times Anything else you'd like Coach Alexander to know?

I understand the virtual intake is a complimentary first step, and the details above help Coach Alexander prepare a safe, personalized experience. *

Thank you. You're one step in.

Coach Alexander will be in touch within 48 hours to schedule your virtual intake.

Odyssey Swim · Greater Portland 1odyssey.info@gmail.com · (503) 962-0177