Prorated Enrolment Request Form
Our current Term 3 27 Jan - 11 April has commenced. Please complete this form to arrange a prorated enrolment commencing from the selected start date below:
**Pool entry of $3 per swimming student applies and is separate to swimming fees.
Please select the first day you are available to commence a prorated enrolment.
Participant's First Name
Participant's Last Name
Participant's Date of Birth
Parent/Guardian's First Name
Parent/Guardian's Last Name
Parent/Guardian's Email Address
Multiple Lessons Per Week?
No, 1 lesson per week
Yes, 2 lessons per week
Yes, 3 lessons per week
Please select swimming level
if you are unsure of what class or swim level please email us at
Parent & Baby
Parent & Toddler
Beginner Learn To Swim
Advanced Learn To Swim
ADV Development Squad
Please select day of class
Please select time slot
3:30pm (Mon - Fri)
3:45pm (Mon - Fri)
4:00pm (Mon - Fri)
4:15pm (Mon - Fri)
4:45pm (Mon - Fri)
5:15pm (Mon - Fri)
Only complete if you have chosen to enrol your child for multiple lessons per week.
If you are booking more than 1 lesson a week, please let us know the day and time for the second and/or third lesson. Upon completing your booking and payment we will manually enter your subsequent lessons in our booking system.
Other preferred days and time slots
Please let us know if there are any other days and times suitable for your child's lesson. If we are no longer able to offer the day of your initial booking we will contact you with alternative days based on your noted preferences.
If you wish to use your $100 Active Kids voucher please add voucher number here*
Questions or Other notes?
How did you hear about us?
Social Media (Facebook/Instagram/Twitter)
I agree to the terms and conditions stated here.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service