Registration Private Adults Swimming Lessons

Salutation

Name(Required)

Phone(Required)

Email(Required)

Address(Required)

Where would you like to hold your lesson?

3 Preferred Timing

e.g.: Monday morning, Wednesday afternoon, Saturday evening

How many toddlers are you registering for?(Required)

Toddler #1

Name

Date of Birth

Gender

Toddler #2

Name

Date of Birth

Gender

Toddler #3

Name

Date of Birth

Gender

Toddler #4

Name

Date of Birth

Gender

Toddler #5

Name

Date of Birth

Gender

Toddler #6

Name

Date of Birth

Gender

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