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Swim Our Way
Term-Time Classes Booking Form
Please copy /print from then send to address below.
11 week Swim Classes Starting Friday 6th, Saturday 7th, Monday 9th, Tuesday 10th & Wednesday 11th January 2012
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:
...
.
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Post Code:
.....................Tel no:
.....................
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Mob no:
Email:...
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Name of school attending:
Call Nicole on 07747606141
Please send forms to:
Our Childrens Activities, 28 Harrow Fields Gardens, Harrow on the Hill, Middx, HA1 3SN
For payments please see 'Payment Method' page.
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