Parent or Guardian Information
Parent First Name
*
Parent Last Name
Email
*
Address
Postal code
*
Phone
*
Swimmer Information
Swimmers First Name
*
Swimmer Last Name
*
Swimmer Date of Birth
*
Current Ability for Each Swimmer
Non-swimmer
Beginner - Can swim 5 metres
Improver - Can swim 10 metres
Advance - Can swim 100 metres
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Does the Swimmer(s) have any medical conditions?
Which term would you like to start?
Spring term - January
Summer term - April
Autumn term - September
ASAP
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How did you hear about us?
Website
Google/Search Engine
Social Media (e.g., Facebook, Instagram)
Word of Mouth/Referral from Family or Friend
Flyer or Poster
Other
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Select your preferred time
Weekdays
Weekends
Either
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