Adult 1-1 and 2-1 Swimming Lessons Booking Form

Adult 1-1 & 2-1 Lesson Bookings

5% Discount off your first course fee, if you book online!

Fields marked with ( ! ) are required.

Applicant 1

Name ( ! )

D.O.B (dd/mm/yyyy) ( ! )

Gender ( ! )

Street Address ( ! )

Town/City ( ! )

County

Post Code ( ! )

Phone ( ! )

Email ( ! )

If having 2-1 Lessons, please fill out applicant 2. Otherwise continue to 'Preferred Lesson Times'

Applicant 2

Name

D.O.B (dd/mm/yyyy)

Gender

Street Address

Town/City

County

Post Code

Phone

Preferred Lesson Time ( ! )

Additional Info (e.g. Medical Requirements & Swimming Ability)

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