Swim Lesson Interest Form
Thank you for your enquiry with S.W.I.M Movement. All our S.W.I.M Educators are qualified and licensed swimming instructors with valid CPR and life safety skills.

Kindly fill up this interest form and we will get back to you.

Please note that we require consent from parents or guardians for learners under the age of 18.
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Name of Swimmer *
A separate form is required if there is more than 1 interested learner.
Name of Parents/Guardians *
Gender of Swimmer *
Date of Birth of Swimmer *
MM
/
DD
/
YYYY
Contact number of Swimmer or Parents/Guardians *
Email address of Swimmer or Parents/Guardians *
Preferred Days *
You may indicate up to 3 preferred day and we will try to accommodate based on Teachers' availability
Required
Preferred Sessions *
You may indicate up to 3 preferred session and we will try to accommodate based on Teachers' availability
Required
Medical or Special Condition (if any)
The information provided here is important for our S.W.I.M Educators to take note of and plan the lesson accordingly for the learners.
Swim Pool Location Preference *
Kindly indicate if you have other swim pools location in mind.
Required
Swimmer's abilities and experience *
Required
How did you hear about us?  *
Required
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