2.

3.

1.

1.

parents’/guardians’ info

2.

first name

surname

date of birth

first name

surname

date of birth

first name

surname

date of birth

first name

surname

first name

surname

email address

phone number

term or course

your contact details

*

*

*

*

*

*

*

*

*

postal address

comments

• day/time that suits you
• water confidence/abilities

(or any other comments)

group type

*