Learn to Swim Enrolment Modification

First Name *

Last Name *

Email Address *

Phone Number *

Student Name *

Student Age *

Student's current class details *

My preferred location is *

Penrith

St Marys

My preferred day/s are *

My preferred time/s are *

Morning

Afternoon

Evening

Any

2nd Student Name

2nd Student Age

2nd Student's current class details

My preferred location is

Penrith

St Marys

My preferred day/s are

My preferred time/s are

Morning

Afternoon

Evening

Any

3rd Student Name

3rd Student Age

3rd Student's current class details

My preferred location is

Penrith

St Marys

My preferred day/s are

My preferred time/s are

Morning

Afternoon

Evening

Any

Please provide any other relevant details, including details of any additional students