Leopold Swim School | Enrolment Form

Last Name*

Address*

Suburb*

Post Code*

Guardian 1's Name*

Guardian 2's Name

Contact Number*

Email*

Swimmer 1

Last Name*

First Name*

Medical History

Age*

DOB (dd/mm/yyyy)*

Babies / Pre-Schoolers

School Age

Last Name

First Name

Medical History

Age

DOB (dd/mm/yyyy)

Babies / Pre-Schoolers

School Age

Comments

Your deposit can be paid by calling the swim school and paying by credit card, or you can come in and pay in person.

Permission

I give Leopold Swim School my permission to show my child’s photograph on advertising material

I understand that I am responsible for the safety of my own child/children when at the premises of Leopold Swim School.*

Comments

This field is for validation purposes and should be left unchanged.