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Intensive Swim Program Enrolment Form

Parent/guardian details
Name:
Address
Program details
Swimming program preferred centre:
Student 1 details
Name:
Has your child previously participated in a swimming program?
Questions N/A 5m 10m 15m 25m
Select the skills that this student can complete

Student 2 details
Name:
Has your child previously participated in a swimming program?
Questions N/A 5m 10m 15m 25m
Select the skills that this student can complete

Student 3 details
Name:
Has your child previously participated in a swimming program?
Questions N/A 5m 10m 15m 25m
Select the skills that this student can complete
Emergency contact
Name:
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