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Adult Swimming Lessons Registration Form (PRIVATE)

All the items starting with * must be completed.

Your Particulars

* Name:

* Contact Number:

* Address1: 

   Address2:

* Postal Code:

* Gender:

Male Female

* Email Address:

Timing and Location

* Number Of Student:

* Preferred Swimming Location:

* Preferred Timing:

1. First Choice: 

2. Second Choice: 

3. Third Choice: 

*Student's Particulars

1. Name:

Date Of Birth:

Level: Beginner Intermediate Advance

2. Name:

Date Of Birth:

Level: Beginner Intermediate Advance

3. Name:

Date Of Birth:

Level: Beginner Intermediate Advance

4. Name:

Date Of Birth:

Level: Beginner Intermediate Advance

5. Name:

Date Of Birth:

Level: Beginner Intermediate Advance

Promotion Code (if any):

   

How did you know about Happy Fish Swim School:


Others, please specify:
   

Remarks:

I have read and agree to Terms and Conditions

 

 

 

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