Lesson Application Form

Please fill out the form below to enquire about enrolling onto our swimming programme.

Student 1

1st Student Name
DOB
Approx Height (m)
Swimming Level
NoneSmall ChildBeginnerAdvanced BeginnerImproverAdvancedAdult
Any Medical Conditions

Student 2

2nd Student Name
DOB
Approx Height (m)
Swimming Level
NoneSmall ChildBeginnerAdvanced BeginnerImproverAdvancedAdult
Any Medical Conditions

Student 3

3rd Student Name
DOB
Approx Height (m)
Swimming Level
NoneSmall ChildBeginnerAdvanced BeginnerImproverAdvancedAdult
Any Medical Conditions
Parent/Guardian Name
Email Address
Address
Town
Postcode
Home Tel
Mobile
General Enquiries