Learn to Swim Form
Please fill in the form below and one of our friendly staff members will be in touch.
Full Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
How did you hear about us?
*
Please Select
Ipswich Show
Social Media
Google
Banner/ Street Signage
Flyer
Friend
Family
Please select what area you are interested in?
*
Please Select
0-1 Years
1-2 Years
2-3 Years
Children over 4 years
Adults
Other
Please select your preferred facility
*
Bellbowrie Pool & Gym
Goodna Pool
Bundamba Swim & Gym Centre
Leichhardt Pool
Rosewood Pool & Gym
Kilcoy Pool
Lowood Pool
More information
Please verify that you are human
*
Submit Form
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