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 Swim Lesson Request Form

“I agree to participating in private swim lessons provided by Ciara Seymore, the owner of Ci Renee Swim. I understand that the progress of the swimming skills taught in the lesson is specific to each child and results may vary. I understand that not all lessons may go as expected and myself or my child(ren)/clients may be unable to complete the full lesson due to discomfort. I understand that I reserve the right to end any lesson at any time. As an experienced instructor, for client safety, Ciara also reserves the right to end a lesson at any time based on best judgment and client response. I understand that in either of the unlikely aforementioned circumstances, I would still be responsible to pay the remaining balance of the lesson. I understand that payments are non-refundable.

I understand and acknowledge that swimming and related activities involve inherent risks, including the risk of serious injury or death. I voluntarily assume all such risks. I release, waive, discharge, and covenant not to sue Ci Renee Swim, the homeowner of the property where the swim lessons take place, and their respective officers, directors, employees, agents, and representatives (collectively, the "Released Parties") from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me (or my child(ren) while participating in swim lessons, whether caused by the negligence of the Ci Renee Swim or otherwise. I agree to indemnify and hold harmless the Released Parties from any loss, liability, damage, or cost they may incur due to my (or my child''s) participation in swim lessons, whether caused by the negligence of the Released Parties or otherwise. I grant permission to Ci Renee Swim to take photographs and/or videos of the participant during the swim lessons and to use such photographs and/or videos for promotional purposes without compensation".

By registering below, I acknowledge that I have read the site completely, agree to allow these services and follow all procedures and guidelines relating to all polices/information outlined on the site. 

Thank you for your request!

Once you send a request,  Ciara will reach out to you within 48 hours to schedule your lesson. All requests are responded to in the order they are received and will be accommodated based on the days/times you are available. If you are unable to be scheduled on your preferred day or time, you will be offered other days/times that may be available within that week.

Once a specific day and time is agreed upon, you will be asked to send full payment for your lesson which can be paid through CashApp ($cireneexo), Venmo (@Ciara-Seymore-1), Apple Pay or Zelle. All payments are non refundable. Once I receive your payment, I will confirm and add you to my calendar! I will also confirm all lessons the day before.

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Summer 2025 Hours

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East Patchogue Location 

Monday - Thursday 10:00 am - 3:00 pm

Holtsville Location (year round)

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Tuesday/Thursday 4:00 pm - 7:00 pm

Sunday 9:00 am - 1:00 pm

2025 Down Island Creative Studios. All Rights Reserved

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