** Your Registration Will Be Placed On Our Waiting List **
Please enter your information in the form below and
press the submit button.
When we start registration for our next session you will be contacted before we open up the registration to the general public.
Personal Information:
Parent's First Name:
Parent's Last Name:
Address:
Post Code:
City:
Home Phone:
Mobile or Work Phone:
E-mail:
Swimmer Information:
Swimmer 1
First Name:
Last Name:
Birthday:
MM
January
February
March
April
May
June
July
August
September
October
November
December
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Gender:
Male
Female
Swimming History:
Choose One:
Current Swimmer
Former Swimmer
Other Swimmer
Beginner
Class Level:
Choose One:
01
02
03
04
05
06
07
08
09
10
Class Preference:
Days
Monday
Tuesday
Thursday
Time
18:00-18:30
18:35-19:05
19:10-19:40
17:00-17:30
17:35-18:05
18:10-18:40
18:45-19:15
19:20-19:50
16:30-17:00
17:05-17:35
17:40-18:10
18:15-18:45
18:50-19:20
19:25-19:55
Second Preference:
Days
Monday
Tuesday
Thursday
Time
18:00-18:30
18:35-19:05
19:10-19:40
17:00-17:30
17:35-18:05
18:10-18:40
18:45-19:15
19:20-19:50
16:30-17:00
17:05-17:35
17:40-18:10
18:15-18:45
18:50-19:20
Swimmer Information:
Swimmer 2
First Name:
Last Name:
Birthday:
MM
January
February
March
April
May
June
July
August
September
October
November
December
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Gender:
Male
Female
Swimming History:
Choose One:
Current Swimmer
Former Swimmer
Other Swimmer
Beginner
Class Level:
Choose One:
01
02
03
04
05
06
07
08
09
10
Class Preference:
Days
Monday
Tuesday
Thursday
Time
18:00-18:30
18:35-19:05
19:10-19:40
17:00-17:30
17:35-18:05
18:10-18:40
18:45-19:15
19:20-19:50
16:30-17:00
17:05-17:35
17:40-18:10
18:15-18:45
18:50-19:20
19:25-19:55
Second Preference:
Days
Monday
Tuesday
Thursday
Time
18:00-18:30
18:35-19:05
19:10-19:40
17:00-17:30
17:35-18:05
18:10-18:40
18:45-19:15
19:20-19:50
16:30-17:00
17:05-17:35
17:40-18:10
18:15-18:45
18:50-19:20
19:25-19:55
Swimmer Information:
Swimmer 3
First Name:
Last Name:
Birthday:
MM
January
February
March
April
May
June
July
August
September
October
November
December
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Gender:
Male
Female
Swimming History:
Choose One:
Current Swimmer
Former Swimmer
Other Swimmer
Beginner
Class Level:
Choose One:
01
02
03
04
05
06
07
08
09
10
Class Preference:
Days
Monday
Tuesday
Thursday
Time
18:00-18:30
18:35-19:05
19:10-19:40
17:00-17:30
17:35-18:05
18:10-18:40
18:45-19:15
19:20-19:50
16:30-17:00
17:05-17:35
17:40-18:10
18:15-18:45
18:50-19:20
19:25-19:55
Second Preference:
Days
Monday
Tuesday
Thursday
Time
18:00-18:30
18:35-19:05
19:10-19:40
17:00-17:30
17:35-18:05
18:10-18:40
18:45-19:15
19:20-19:50
16:30-17:00
17:05-17:35
17:40-18:10
18:15-18:45
18:50-19:20
19:25-19:55
Further Information:
Comments:
How were you referred to us:
Current Swimmer
Former Swimmer
Parent of Swimmer
Friend or Family Member
Advertisement
Internet
Mailing
Other
Name/Other:
Please add me to your E-Mail list:
Yes
No
If you see the page refresh then your registration has been received.
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