Financial Hardship Free Swim Lessons
These lessons are for children aged between 5 and 16 whose families are struggling financially and would not normally be able to pay for swim lessons - there is limited places.
Community service card number
*
Community service card expiry date
*
Child’s name
*
First Name
Last Name
Parent/caregivers name (must match name on your community service card)
*
First Name
Last Name
Child’s birth Date
*
-
Day
-
Month
Year
Date
Write age in years
*
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Swimming ability
Junior - no swimming ability
Beginner - is confident can put head under water and can tread water
Intermediate - has some breathing and stroke technique
Senior - can do most techniques with correct breathing
Has your child done swimming lessons before
Yes
No
Submit
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