Name of Parent / Applicant *
Mobile Number *
Email *
Name of student 1*
Name of student 2
Student Date of Birth 1
Student Date of Birth 2
Location of Teaching Venue *
Preferred day * MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Starting Date *
Preferred Time slot *
Type of Swimming Lesson * Toddler swimming lessonKids swimming lessonAdult swimming lesson
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Enquiry/Remarks
