Family Name:
Child Name(s):
(1)
D.O.B
(2)
D.O.B
(3)
D.O.B
Address:
Phone:
(Home)
(Mobile)
Email:
Parent/Carers Name(s):
Does your child(ren) have any disabilities, medical conditions eg. Asthma, learning/behavioural issues that we should be aware of?
No
Yes (please specify)
Pool:
Unanderra
Towradgi
Please comment on any preferences of day, time etc
How did you find out about McKeon Swim School?
Internet
Yellow Pages
Referal from family/friend
Other
Why did you choose McKeon Swim School?
Referral from family/friend
Previously attended lessons
Proximity to home
Other