Parent/guardian details Name First Last Best contact number Email address Cancellation details Reason for cancelling Changing to another swim school Financial difficulty Change of season Other… Enter other… Leisure Centre Churchill Moe Newborough Morwell I would like to be contacted about reinstating my booking at a later date Contact me after date Student 1 details Name First Last Date of birth Last date student will attend Add another student to this form Student 2 details Name First Last Date of birth Last date student will attend Add another student to this form Student 3 details Name First Last Date of birth Last date student will attend Leave this field blank
