Swim Lesson Level Questionnaire

This questionnaire is meant to help parents find out what level is best to start their child in for
swim lessons.

Read each question and answer them to the best of your ability, using “yes” or “no” answers. For
the first “no” you write, that will be the correct level to place your child in.

After the first day, level placement will be up to the instructors, depending on the child’s
performance in class.

LEVEL 1

Is your child comfortable in the water? _______________

Can your child put his/her face in the water? _______________

Can your child blow bubbles through his/her mouth and nose? _______________

LEVEL 2

Can your child put his/her whole body (head included) under the water? _______________

Can your child attempt to float on their tummy? _______________

Can your child push off from the wall on their tummy? _______________

LEVEL 3

Can your child open their eyes under water? _______________

Can your child attempt to float on their back? _______________

Can your child push off from the wall on their back? _______________

LEVEL 4

Does your child have a strong and steady kick when they swim? _______________

Can your child jump into water by themselves? _______________

Can your child use the ladder/side to exit the water by themselves? _______________

LEVEL 5

Does your child use proper freestyle arms when swimming? _______________

Does your child use their arms and legs simultaneously while swimming? _______________

LEVEL 6

Does your child use proper backstroke arms when swimming? _______________
Can your child tread water for at least 30 seconds? _______________

LEVEL 7

Can your child swim with proper freestyle technique? _______________

Can your child freestyle for at least 25 meters? _______________

LEVEL 8

Can your child swim with proper backstroke technique? _______________

Can your child backstroke for at least 25 meters? _______________

LEVEL 9

Can your child swim freestyle with proper rhythmic breathing? _______________

Can your child streamline under the water? _______________

LEVEL 10

Can your child perform surface, kneeling, and deep angle dives? _______________

Can your child do flip turns while swimming? _______________