Children Swimming Club - Registration Form

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Before filling in this form, please ensure that you are a Panaga Club member.

Please note that the minimum age to register is 3 months. There is currently a waiting list and there is no need to fill this form in again if you do not hear back immediately. If you would like to go on the waiting list for both Group and Private/Semi Private lessons to see which option becomes available first, please fill in a separate form for both options. Once a slot is available, you will be contacted via Whatsapp and authorize the club to deduct the lesson fees.

Note: In case you want to register multiple person, please fill in a separate form per person!

Email *

Membership Number *

Apply For *

Baby & parents $30 per month (30 minute lesson) only for 3 month – 2 years 9 months old

Children Group Lessons - $30 - $40 per month (30 - 45 minute lesson depending on swim level)

Children Private Lessons - $35 per 30 minute lesson

Children Semi-Private Lessons - $20 - $15 per 30 minute lesson (Group of 2 - 4 youth)

Competitive Squad - $70 - $105 per month per 60-90 minute lesson 2-6 times a week. (Your child will be invited for an assessment to determine readiness to join the squad)

Required

Swimmer's First Name *

Swimmer's Last Name *

Swimmer's Date of birth *

YYYY

Swimmer's gender *

Male

Female

Required

Name of School Attended *

School Year (Y1, Y2, etc.) *

Swimming Ability *

Fearful

Beginner

Intermediate

Advanced

Required

Additional Information (e.g. does not like to put head under water, can swim without aid, needs assistance such as floats)

Principal Member’s Name *

Parent's full name

Spouse's Name *

Primary Contact
*

Principal member

Spouse

Required

Primary Email address *

Preferably email address to receive emails

Secondary Email Address *

Primary Contact Number *

Mobile number to receive text messages at Whatsapp

Secondary Contact Number *

Brunei mobile number to receive SMS/call

INDEMNITY AND PARENTAL COMMITMENT/AUTHORISATION

I/We and/or my/our family acknowledge:

Any persons entering the Club’s property and/or using the Club’s facilities:

- do so entirely at own risk and neither the Club nor the Club’s management, volunteers or committee members, members or any employees shall be liable in any manner whatsoever for:
- any claim or damage arising or suffered either directly or indirectly from personal injury or harm whatsoever, including death, or any damage whether direct or indirect to personal or other property whatsoever, and howsoever caused.
shall, by doing so, be deemed to indemnify the Club against any liability for damages, howsoever caused.

I have read and agree to the Indemnity and Parental Commitment / Authorisation *

Yes

Required

I/We have read and understand the Stingrays Information Sheet including information on lesson fees (click here Swim Information Sheet) *

Yes

Required

I/We understand that there is a monthly fee and hereby authorize the Panaga Club to deduct from my Panaga Club account. Monthly fees for Group Lessons are charged every month, regardless of school holidays, breaks, etc. Full monthly fees for Group Lessons are payable according to squad level, regardless of the number of lessons or training sessions that are attended. Semi-Private and Private lessons are billed per lesson; lessons will be billed regardless of attendance, unless prior agreement has been made. Semi-Private and Private Lessons will not be billed during school holidays or if StingRays Swim Club cancels the lesson. *

Yes

Required

A copy of your responses will be emailed to the address you provided.

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