Family Name:
1st Childs Name: DOB: Sex: Male: Female: Medical Conditions:
2nd Childs Name: DOB: Sex: Male: Female:Medical Conditions:
3rd Childs Name: DOB: Sex: Male: Female:Medical Conditions:
4th Childs Name: DOB: Sex: Male: Female: Medical Conditions:
Parents Names: Home Number: Mobile Number:
Postal Address: Post Code:
Email Address:
Emergency Contact: Phone Number:
If your child/ren is unable to attend a class, please call us on 49531744 to arrange a make-up lesson. Please note that the make-up is only for the child who is sick. If you do not phone, you forfeit that lesson. We only allow two make-ups per swimmer per term. If you cancel your make up you forfeit the lesson. The classes must be completed in the Term they are purchased.
I agree to the above terms and conditions. I AGREE
I would like to change to/ enrol for the following lessons: (Change to & enrol for will depend on availability of classes due to our roll over policy for current swimers.)
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