Book an Online Private Lesson

Remote Learning

Use this form to book a private lesson, taught online via Zoom.

Contact Information

Your Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Your Email *

Confirm Email

Phone Number

Do you have a preferred pronoun(s)?

Lesson Information

Preferred day of week for lesson(s):

Preferred time of day (Pacific Time) for lesson(s):

**ALL TIMES SHOWN ARE PACIFIC TIME** Pick your desired 2 hour time block for your lesson. You can choose more than one time block. We will make every effort to schedule your lesson in your chosen time block(s), based on instructor availability.

How long would you like the lesson to be? (30 minutes minimum) *

Please choose the roller skating level/experience that best describes your current skill level.

Other skating experience, please describe (optional)

Indicate your desired area of interest you'd like your lesson to focus on

Any additional information you feel your instructor should know prior to your lesson?

Would you like to set up a recurring lesson?

Name

Thank you from the Roller Skate Victoria Team.