Makeup Lesson Request Form

Please complete the form below to request a makeup lesson for your swimmer.

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This field is for validation purposes and should be left unchanged.
Last Name*
Guardian 1's Name*
Email*
Contact Number*
Swimmer 1
Last Name*
First Name*
Current day of lesson
Current time of lesson

: Hours

Minutes

AM/PM
Preferred make up lesson date (dd/mm/yyyy)*
Preferred make up lesson date (dd/mm/yyyy)
Day
Month
Year
Swimmer 2
Last Name
First Name
Current day of lesson
Current time of lesson

: Hours

Minutes

AM/PM
Preferred make up lesson date (dd/mm/yyyy)
Preferred make up lesson date (dd/mm/yyyy)
Day
Month
Year
Comments
Please note: Term fees must be paid in full for your makeup lesson request to be processed. Please read Leopold Swim School Makeup lesson policy.

Swimmer 1