Adult Squad Enrolment Form
First Name
Your answer
Last Name
Your answer
Contact Number
Your answer
Email Address
Your answer
Medical Conditions
Your answer
Member of Blue Mountains Phoenix Swimming Club?
Members of the swimming club receive a 5% discount on their squad fees.
Squad Start Date
MM
/
DD
/
YYYY
Emergency Contact Number
Your answer
Emergency Contact Name
Your answer
Invoice Type
If you only swim once a week or the odd session choose 10 visit pass otherwise choose per term. 10 visit passes can be purchased directly from the website after registration.
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