Contact Form

Parents First Name

Parents Last Name

Pupils First Name

Pupils Last Name

Mobile Number

The following options allow us to contact you about your lessons, please tick as many as you can so we may provide you with the best service:

Can we contact you via email about swimming lessons?

Can we contact you by phone about swimming lessons?

Can we text you with details on classes, traffic delays, and pool closures?

From time to time we may take photos for use on our web site, facebook and social medial sites for promotions purposes.

Do you give us permission to take photos that include your child?

Address line 1

Address Line 2

Town

Postcode

Pupils Date Of Birth

Swimming Aids

Can the pupil swim without buoyancy aids

Yes No

Swiming Distance

Badges and certificates

Swiming Ability

Preferred day(s) of week

Preferred times(s) of day

Medical or behavioural conditions

How did you hear about us?

Please confirm you have read these three pages links are on the bottom of every page of our web site:

Read out terms and conditions

Read our pool rules

Read our disclaimer form