Swimming Enrollment Form

 

Name and surname of child (Swimmer)  :  *
Age  :  *
Date of birth  : 

*

Any previous lessons : Yes No*
Is your child a : Beginner Intermediate Advanced Baby Swimmer*
Any bad experiences with water (Please elaborate) :

*

Parent/Guardian Details
Name and surname : *
ID Number of parent/guardian : *
Street Address :

*

E-mail : *
Telephone Number : *
Does your child have  :  Allergies Asthma Epilepsy Dizzy Spells Ear Problems e.g.:grommets/constant middle ear infection*
Other relevant information about your child :

*

 

 


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