child registration

Gender* Female Male

Preferred form of contact* Phone Email

Gender* Female Male

Has your child attended lessons before?* Yes No

If yes, what can they do?*Select one Fully submerge (go under water) confidently Float, glide and kick unaided on their front and back Roll to breathe and back kick for 15 metres I don't know / I'm not sure

Which pool would you prefer to have lessons at?* Huia Stokes Valley Wainuiomata (only available for Term 4 2019 and Term 1 2020)

Do you give us permission to carry out observations, and take and use digital images of your child for staff training, programme planning and advertising?* Yes No