Parent and Baby Swimming Registration Form

Aquability

Empowering Swimmers. Developing Exceptional Instructors.

Parent & Baby Swimming Registration Form

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Baby / Toddler Name *

First

Last

Age *

Date Of Birth (dd/mm/yyyy) *

Gender *

Parents / Carers Name *

Telephone Number Daytime *

Telephone Number Evening *

Address *

Email *

Email

Confirm Email

Daycare Presently Attending (if any) *

Details of person or persons who will accompany baby / toddler in the pool *

adult Your For

Any health issues for accompanying adult *

Swimming Ability & Water Confidence of accompanying adult *

Health issues of baby / toddler *

Swimming experience & Water Confidence of baby / toddler *

What Are You Hoping Your Child Will Gain From Parent and Baby Swimming Lessons *

Days Able To Attend *

Days & Times UNABLE To Attend: Tues to Sat, 9:00am - 5:30pm *

Any other relevant information

Do You Give Permission For Your Photos/Videos To Be Used For Promotional Purposes? *

How Did You Hear About Us? *

Aquability Terms and Conditions Including Disclaimer *

Please Enter Your Full Name As This Will Be Your Electronic Signature *

Todays Date *

Telephone : +1 246 236 2830