St Brieux Regional Park Swimming Lessons Form

St Brieux Regional Park Swimming Lessons Form

2026
Parent Name*

First NameLast Name
Childs Name*

First NameLast Name
Childs Current Age*
Childs Date Of Birth*

MonthDayYear
Date
Phone Number*
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

Town / CityRe

Postal Code
Week of July 13-July 17Week of July 27-July 31
PreschoolSwimmer 3Swimmer 5Swimmer 1Swimmer 4Swimmer 6Swimmer 2
Payment can be made at Gatehouse and is required before child can participate in lessons. Signed Authorization form must also be signed at gatehouse by parent/gaurdian before lessons begin.
Should be Empty: