JOMRENANG SWIM CLASS *PRIVATE/PERSONAL
JOMRENANG ACADEMY
Email address *
Adakah anda bersetuju dengan terma dan syarat jomrenang? Sila baca sebelum mendaftar. Terima kasih. / Read and Agree the Rules before Sign-Up. Rujukan/Ref. >>> http://jomrenang.com/jomrenang-rules/ *
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Pilihan Pakej Personal / Personal Package Options *
Nama Pelajar / Student's Name *
No. Telefon / HP Number *
Umur pelajar/Student's Age *
Jantina/Gender *
Saringan Tahap Kesihatan / Health screening *
Tidak Sihat/ Unhealthy
Sihat dan Fit/ Healthy and Fit
Maklumkan jika ada masalah kesihatan / Health statement if any
MAKLUMAT IBU/BAPA/PENJAGA / PARENTS INFORMATION
(PELAJAR BAWAH 12 TAHUN / MASIH DIBAWAH JAGAAN / BELOW 12 / UNDER GUARDIANS)
Nama Ibu/Bapa/Penjaga / Parent's / Guardian's Name
No. Telefon/ HP Number
***PERAKUAN / AGREEMENT APPROVAL *
Tarikh Daftar / Date of Registration *
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DD
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YYYY
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