Learn to Swim Enrolment Form

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Contact Number *

Parent/Guardian Address *

Pupils Name *

First

Last

Pupil Date of Birth *

Please Note: Children must be 4 years of age to start

Swimming Experience *

Children starting with previous experience will be assessed prior to starting to ensure your child begins at the right level

Health Issues *

Special Needs/ Requirements *

Pupils Name (Second Child)

First

Last

Please Note: Children must be 4 years of age to start, Children starting with previous experience will be assessed prior to starting to ensure your child begins at the right level

Date of Birth (Second Child)

Please Note: Children must be 4 years of age to start

Swimming Experience (Second Child)

Children starting with previous experience will be assessed prior to starting to ensure your child begins at the right level

Health Issues (Second Child)

Special Needs/ Requirements (Second Child)

Pupils Name (Third Child)

First

Last

Please Note: Children must be 4 years of age to start,

Date of Birth (Third Child)

Please Note: Children must be 4 years of age to start

Swimming Experience (Third Child)

Children starting with previous experience will be assessed prior to starting to ensure your child begins at the right level

Health Issues (Third Child)

Special Needs/ Requirements (Third Child)

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Learn to Swim Enrolment Form

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