Please enter all your details to enroll your child

Contract Options

Registration Fee Options (Per Swimmer): *

R320 = Once off registration fee Includes swim cap, swim bag, kick board)

R100 = Additional once off should you require a dreadlocks cap

R100 = Any re- registrations within a 12 month period

Contract Options Child: *

R620p/m = Month to Month

R580p/m = School Group - Vaal Triangle (Include bus fee)

R580p/m = School Group - Curro (Include bus fee)

Other

If Other Contract is Selected

Amount Payable

Promotion Name

Swimmers Details

Section A

Nickname *

Surname *

Certificate Name *

This name will be displayed on the certificate

Age *

Date of Birth *

Gender *

Male

Female

Academic School Attending *

Grade *

Previous Swim Lessons *

Yes

No

Swimming Ability *

Beginner

Water Confident

Stroke Development

Medical Information

Section B

Near Drown Experience *

Yes

No

Near Drown Experience: If Yes, Explain

Parents Details

Section C

Dad Name & Surname *

Dad Cellphone Number *

Mom Name & Surname *

Mom Cellphone Number *

Can we send you marketing info? *

Yes

No

Emergency Contact

Section D

Emergency Contact Name & Surname *

Relationship *

Emergency Contact Cellphone Number *

WhatsApp Communication Details

Section E

WhatsApp Name & Surname *

WhatsApp Cellphone Number *

Photography / Video Consent

Section F

Photography / Video Consent *

Yes

No

Terms & Conditions

Section G

View T's & C's

Terms & Conditions *

Accept

Bus Indemnity acceptance if School Group Contract is selected

Signature *

Clear