Locks Heath Swim School Registration Form
Child’s Forename *
Child’s Surname *
Date of Birth *
MM
/
DD
/
YYYY
School attended *
E-Mail Address *
First Line of Address *
Post Code *
Home Phone Number
Mobile Phone Number *
Relevant Medical Information
Special Educational Needs
Parent/Guardian to print name as signature to confirm have read and agree with Regulations and Procedures displayed at locksheathswimschool.co.uk *
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