Parent Contact Information

Child 1 Particulars

Child 1 - First Name and Surname

Child 1 - Date of Birth

Child 1 - Swimming Ability
Require a mums and bubs class (for children under the age of 3)Comfortable in the water, happy to put face under waterCan confidently and independently push off to teacherCan swim long arm paddling and independently float on backCan do overarm swimmingCan do freestyle and backstroke for 8 metresCan do freestyle, backstroke and breaststroke for 10 metresRequires a squad classOther (specify below)

Child 1 - Preferred Day / Time for Lessons
Monday morningMonday afternoonTuesday morningTuesday afternoonWednesday morningWednesday afternoonThursday morningThursday afternoonFriday morningFriday afternoonSaturday morning

Child 2 Particulars

Child 2 - First Name and Surname

Child 2 - Date of Birth

Child 2 - Swimming Ability
Require a mums and bubs class (for children under the age of 3)Comfortable in the water, happy to put face under waterCan confidently and independently push off to teacherCan swim long arm paddling and independently float on backCan do overarm swimmingCan do freestyle and backstroke for 8 metresCan do freestyle, backstroke and breaststroke for 10 metresRequires a squad classOther (specify below)

Child 2 - Preferred Day / Time for Lessons
Monday morningMonday afternoonTuesday morningTuesday afternoonWednesday morningWednesday afternoonThursday morningThursday afternoonFriday morningFriday afternoonSaturday morning

Child 3 Particulars

Child 3 - First Name and Surname

Child 3 - Date of Birth

Child 3 - Swimming Ability
Require a mums and bubs class (for children under the age of 3)Comfortable in the water, happy to put face under waterCan confidently and independently push off to teacherCan swim long arm paddling and independently float on backCan do overarm swimmingCan do freestyle and backstroke for 8 metresCan do freestyle, backstroke and breaststroke for 10 metresRequires a squad classOther (specify below)

Child 3 - Preferred Day / Time for Lessons
Monday morningMonday afternoonTuesday morningTuesday afternoonWednesday morningWednesday afternoonThursday morningThursday afternoonFriday morningFriday afternoonSaturday morning

Child 4 Particulars

Child 4 - First Name and Surname

Child 4 - Date of Birth

Child 4 - Swimming Ability
Require a mums and bubs class (for children under the age of 3)Comfortable in the water, happy to put face under waterCan confidently and independently push off to teacherCan swim long arm paddling and independently float on backCan do overarm swimmingCan do freestyle and backstroke for 8 metresCan do freestyle, backstroke and breaststroke for 10 metresRequires a squad classOther (specify below)

Child 4 - Preferred Day / Time for Lessons
Monday morningMonday afternoonTuesday morningTuesday afternoonWednesday morningWednesday afternoonThursday morningThursday afternoonFriday morningFriday afternoonSaturday morning

Additional Information

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