• Date Today*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Format: 0000000000.
  • I am interested in*
  • Student Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Are you looking to enrol?*
  • As of next year, has {child_name} started Primary School?*
  • Image field 80
  • Has {child_name} had any swimming lessons previously?*
  • Image field 82
  • Has {child_name} had any swimming lessons previously?*
  • Image field 84
  • Has {child_name} had any swimming lessons previously?*
  • Image field 86
  • Can {child_name} swim independently - no flotation aids?*
  • Image field 88
  • Can {child_name} swim 12m freestyle with a basic breathing pattern?*
  • Image field 90
  • Can {child_name} submerge?*
  • Image field 92
  • Can {child_name} swim independently and are they able to perform basic freestyle?*
  • Image field 94
  • Is {child_name} confident and able to swim independently?*
  • Image field 96
  • Can {child_name} swim 10m freestyle?*
  • Image field 98
  • Can {child_name} swim freestyle & backstroke?*
  • Image field 100
  • Can {child_name} confidently swim freestyle and backstroke, basic breaststroke and butterfly kick?*
  • Image field 102
  • Is {child_name} confident and able to swim independently?*
  • Image field 104
  • Can {child_name} swim freestyle & confidently kick on back?*
  • Image field 106
  • Can {child_name} swim independently?*
  • Image field 109
  • Can {child_name} swim freestyle?*
  • Image field 111
  • Can {child_name} swim backstroke?*
  • Image field 113
  • Can {child_name} confidently swim 10m freestyle & backstroke?*
  • Image field 115
  • Can {child_name} perform breaststroke kick?*
  • Image field 117
  • Can {child_name} swim breaststroke and butterfly?*
  • Image field 119
  • Is {child_name} ready for a squad program?*
  • Image field 121
  • Which days suit you best?*
  • What times of day suit you?*
  • Are any other Students swimming with us?*
  • Other Child Class Preference*
  • Workout pass start date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Workout pass end date
     - -
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: