Swimming Lessons Waiting List

Swimming Lessons Waiting List

If you have more than one child please fill in the form again.
Please fill in the form below if you are interested in joining the scheme but please also be aware it will still a significant amount of time before we are able to process new applications.
Parents Name*

First NameLast Name
Childs Name*

First NameLast Name
DOB of child*
Type of lesson*
Does your child have any medical conditions / SEND needs?*
Are you applying for more than 1 child?*

YesNo
Second Childs Name*

First NameLast Name
DOB of second child*
Type of lesson*
Non-swimmers: These are individuals who are not able to swim at all.

Beginner swimmers: These swimmers can move around in the water, but would not be safe out of their depth without buoyancy equipment.

Improver swimmers: These swimmers are capable of swimming at least 10 meters both front and back.
Does your second child have any medical conditions / SEND needs?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Location*
Please verify that you are human*
Should be Empty: