Parent Full Name

Contact Number

Email Address

Swimmer Name

Swimmer Date of Birth

Any Medical Conditions

Have they been in the water before?

Will a parent be required in the water? Will a parent be required in the water? Yes No

Please let us know when you would be able to attend?

Do you have a preference of either of our venues?

Do they currently attend Nursery?

How did you hear about Le Mourier?

Please let us know any additional information here

Terms and Conditions Terms and Conditions I have read and understood the Terms and Conditions

Parent Full Name

Contact Number

Email Address

How many swimmers would you like to join? How many swimmers would you like to join? 1 2 3

Swimmer 1 Name

Swimmer 1 Date of Birth

Any Medical Conditions

How do they swim currently?

Swimmer 2 Name?

Swimmer 2 Date of Birth

Any Medical Conditions

How do they swim currently?

Swimmer 3 Name

Swimmer 3 Date of Birth

Any Medical Conditions

How do they swim currently?

Please let us know when you would be able to attend?

Do you have a preference of either of our venues?

Which School do they currently attend?

How did you hear about Le Mourier?

Please let us know any additional information here

Terms and Conditions Terms and Conditions I have read and understood the Terms and Conditions

Full Name

Contact Number

Email Address

Date of Birth

Any Medical Conditions

Please let us know when you would be able to attend?

Do you have a preference of either of our venues?

How did you hear about Le Mourier?

Please let us know any previous experience here

Please put any additional information here

Terms and Conditions Terms and Conditions I have read and understood the Terms and Conditions

Full Name

Contact Number

Email Address

Message