Swim Our Way

 

Please copy /print from then send to address below.

 

11 week Swim Classes Booking Form

Starting Friday 8th, Saturday 9th, Monday 11th, 
& Wednesday 13th January
2010 

 

Please complete all information in block capitals

 

Child Details

Name of Child (1):……………………………………………………………………………………………………………………………………….

Date of Birth:………………………………………………………Medical/Special needs: ……………………………………..……

Level of Swimming:…………………………………………………………………………………………………………………………………….

1st Choice of day:………………...…….1st Choice of time:……………………..2nd Choice of time:…………………….

2nd Choice of day:………………...……1st Choice of time:………………………2nd Choice of time:……………………

 

Name of Child (2):……………………………………………………………………………………………………………………………………….

Date of Birth:………………………………………………………Medical/Special needs: ……………………………………..……

Level of Swimming:……………………………………………………………………………………………………………………………………..

1st Choice of day:………………...…….1st Choice of time:……………………..2nd Choice of time:…………………….

2nd Choice of day:………………...……1st Choice of time:………………………2nd Choice of time:……………………

 

Name of Child (3):……………………………………………………………………………………………………………………………………….

Date of Birth:………………………………………………………Medical/Special needs: ……………………………………..……

Level of Swimming:……………………………………………………………………………………………………………………………………..

1st Choice of day:………………...…….1st Choice of time:……………………..2nd Choice of time:…………………….

2nd Choice of day:………………...……1st Choice of time:………………………2nd Choice of time:……………………

Person to Contact:

Name of Parent/Guardian  Title: ……………..Name:……………………………………………………………………………..…

Address: ……………………………………………………………….………………………….……………………………………………………….

Post Code: …………………………………………………………Tel no:…………………………………………………………………………..

Mob no:………………………………………………………Email:……………………………………………………………………………………..

Name of school attending:………………………………………………………………………

 

Spaces are limited so call now to secure your booking!

 

Call Nicole on 07747606141

 

Please send payments to:

‘Our Children’s Activities’, 28 Harrow Fields Gardens, Harrow on the Hill, Middx, HA1 3SN

 
 
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