Child Registration

All bookings have now closed for Term 3 2021

We will not be taking any bookings until further notice

Huia pool - 7 days , all levels.
Stokes Valley - we offer a school age programme weekly on Thursday

parent/caregiver details

First name*

Last name*

Relationship to child*

Gender* Female Male

Street address*

Suburb*

Postcode*

Phone number*

Email address*

Preferred form of contact* Phone Email

child 1 details

First name*

Last name*

Date of birth* (use format dd/mm/yyyy)

Gender* Female Male

lesson type

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 lesson level are you interested in for your child?*

If there are special requirements or medical conditions that we need to be aware of list them here. E.g. bad water experiences or language barriers.

child 2 details

First name*

Last name*

Date of birth* (use format dd/mm/yyyy)

Gender* Female Male

Lesson type

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 lesson level are you interested in for your child?*

If there are special requirements or medical conditions that we need to be aware of list them here. E.g. bad water experiences or language barriers.

child 3 details

First name*

Last name*

Date of birth* (use format dd/mm/yyyy)

Gender* Female Male

Lesson type

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 lesson level are you interested in for your child?*

If there are special requirements or medical conditions that we need to be aware of list them here. E.g. bad water experiences or language barriers.