Naper Carriage Hill Swim & Racquet Club 

Swim Lesson Report Card 

1 

Meets Expectations 

2 

Emerging Skill 

3 

Unwilling to Try 

Level One 

Swimmer ________________________________ 

Instructor ________________________________ 

All 1’s are required to proceed to the next level 

Skill                                                                                        

_____   Enter and exit the pool safely using a ladder, steps, and   side of the pool.  

_____   Submerge mouth, nose, and eyes. 

_____   Exhale underwater (blow bubbles) through mouth and nose  for at least three seconds. 

_____   Open eyes underwater and pick up a submerged object held   at arms’ length. 

_____   Show comfort maintaining a front float position while supported  for at least five seconds.  Face may be in or out of the water. 

_____   Recover from a front float (while supported) to a standing  position. 

_____   Show comfort maintaining a back float position while  supported. 

_____   Recover from a back float (while supported) to a standing  position. 

_____   Demonstrate a front glide for two body lengths while supported 

_____   Demonstrate a back glide for two body lengths while supported 

_____   Change direction of travel while walking on the bottom. 

_____   Roll over from front to back while supported. 

_____   Roll over from back to front while supported. 

_____   Swim on front using any combination of arm and leg actions  while supported for at least five feet. 

_____   Swim on back using any combination of arm and leg actions  while supported for at least five feet. 

_____   Demonstrate arm and leg motions for treading water while supported 

_____   Discuss water safety rules and how to call for help. 

Exit Skills Assessment (if applicable) 

_____   Enter unassisted, move 5 yards without use of the wall, bob  5 times to chin level and safely exit the water.  

_____   Float on front with support for 3 seconds, rollover onto back   With assistance, float on back with support for 3 seconds. 

Recommendation for next session: _____________________________ 

Instructor Signature: ________________________________________ 

* Please retain this copy for your own reference. 

Instructor Comments