Registration Form
Abilities Program
Athlete Details
Abilities Program Sessions
*
3 x sessions ($120)
8 January ($25)
15 January ($25)
22 January ($25)
Swimmer's Full Name
*
First Name
Last Name
Birth Date
*
-
Day
-
Month
Year
Date
Gender
*
Male
Female
School Attending
*
Swimming History
How did you hear about our program?
Have you participated in swimming lessons or programs before?
*
Yes
No
Please provide details (e.g., name of program, duration):
How would you describe your swimming ability?
Beginner (e.g., limited water confidence, learning basic strokes)
Intermediate (e.g., can swim 25 meters, familiar with some strokes)
Advanced (e.g., can swim multiple strokes, comfortable in deep water)
Which strokes can you swim confidently? (Select all that apply)
*
Freestyle
Backstroke
Breaststroke
Butterfly
None
Are you interested in participating in swimming competitions?
Yes
No
Not sure
What is your primary reason for joining the program?
*
Fun and fitness
Competitive swimming
Improving specific skills
Other
Do you have any additional notes, including relevant medical history or support needs, that we should be aware of?
*
Contact Details
Parent / Guardian
Full Name
*
First Name
Last Name
Postal Address
Street Address
XX
Suburb
Postcode
Post Code
Mobile
*
Please enter a valid phone number
Email
*
Registration confirmation willl be sent to this address
Register
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