AquaDucks Registration Form - Hollandse Club
Please complete one registration form per student.
This form should only be completed for NEW students, or for students who are RE-REGISTERING after a break.
Student's Particulars
please tick *
Required
Date of Birth (dd-mm-yy) *
Your answer
Name:First / Last name *
Your answer
Email *
Please double-check your email to make sure it is accurate.
Your answer
Mobile Number *
Please note this number will be used as the emergency contact.
Your answer
HC Membership Number *
Your answer
Medical History (Confidential) *
Your answer
Comments
Your answer
Parent's Particulars
Parent's First/last Name
Your answer
Desired Start Date
Please indicate the desired start date (dd-mm-yy): *
Your answer
Terms fee's and term price (excluding gst)
Term 3 2018 30 July – 7 October (10 weeks)
Term 2 2018 8 October – 16 December (10 weeks)

Parent and child /Pre school / Learn to swim weekdays : $300,-
Parent and child /Pre school / Learn to swim weekends : $330,-
(for the 30min/45/60min lesson second lesson is for free if available only on weekdays)
Stroke and Development / waterpolo : $300,-
Adults swim lesson/training 3x a week single : $150,-
Adults swim lesson/training 3x a week Couple : $200,-
Aqua fit : $100,- (10 weeks)
Award swimming / Dutch abc : $30,-
Competition fee per tournament : $15,-
Terms and Conditions (T&C) for Kids lesson
1. A registration fee of $30 applies.
2. Participants are advised that there will be no refund or pro-ration for lessons missed.
3. No lessons take place on official Public Holidays.
4. Payment will be made at the beginning of each term.
5. If there is a need to cancel, please submit the CANCELLATION FORM to Aquaducks 2 weeks before the new term start. Email, SMS, or verbal notices of cancellation are not acceptable. Please notify us in time. Late notification will result in the full term fee being charged.There is an 2 weeks notice to cancel before the new term start.
Terms and Conditions (T&C) for Adults lesson
1. A onetime registration fee of $30 applies.
2. Participants are advised that there will be no refund or pro-ration for lessons missed.
3. No lessons take place on official Public Holidays;
4. Payment will be made at the beginning of each term.
5. If there is a need to cancel, please submit the CANCELLATION FORM to Aquaducks 2 weeks before the new term start. Email, SMS, or verbal notices of cancellation are not acceptable. Please notify us in time. Late notification will result in the full term fee being charged.There is an 2 weeks notice to cancel before the new term start.
Terms and Conditions (T&C) for Aquafit
1. Participants are advised that there will be no refund or pro-ration for lessons missed.
2. No lessons take place on official Public Holidays.
3. Payment will be made at the beginning of each term.
4. If there is a need to cancel, please submit the CANCELLATION FORM to Aquaducks 2 weeks before the new term start. Email, SMS, or verbal notices of cancellation are not acceptable. Please notify us in time. Late notification will result in the full term fee being charged.There is an 2 weeks notice to cancel before the new term start.
Please indicate that you have read and accept the above T&Cs for Kids, Adults OR Aquafit lesson *
Required
Please indicate your agreement below. *
Required
Indemnity
I, the parent from the above section, hereby undertake to indemnify Swim Centre Verhoef (AquaDucks) and the Hollandse Club against any liability, expense, cost or proceedings whatsoever arising in respect of any personal injury or death of any person or damage to any property arising out of or suffered as a result of participation in the above course/activity. I, the applicant accept all the terms and conditions of this form. Please debit the registration fee and the course fee from my account on a monthly basis, until the Aquaducks receives a cancellation (in accordance to the Terms & Conditions).
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