SUMMER HOLIDAY PROGRAM OPTIONS
Please complete the following form to indicate your preference for your Swimming and Water Safety membership over Summer. Dates: 15 December 2017- 15 January 2018

***A form needs to be completed for each student individually***

Please be aware if the form is not completed by Sunday 10 December your payments will continue.

Regular Weekly lessons will resume from Monday 15 January 2018

Students Name
Student Full Name *
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Current Swimming Level (if known)
Your answer
Responsible Person Full Name *
Your answer
Contact Phone Number *
Your answer
E-mail *
Your answer
Preference for Summer Holidays *
Preference for Intensive Lesson Time
Submit
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