1) CONTACT DETAILS

1a) Salutation

1b) Your Name

1c) Your Contact Number

1d) Your Email

1e) Your Address


2) LESSON DETAILS

2a) Type of Swimming Lessons

2b) Preferred Location

2c) If others, please specify location: (address of condo/apartment/swimming complex)

2d) Class Size Preference
Individualgroup


3) STUDENT'S DETAILS

3a) Name of Student

3b) Date of Birth (please enter in dd/mm/yyyy format)

3c) Additional Information (name of more students, special requirements etc)