Tuesday 10 December 2019
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Learn to Swim Enquiry Form - Laidley

Full Name(*)
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Email(*)
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Childs Date of Birth(*)
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Phone
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Address
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Enquiry
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Type of Program
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Preferred Day for Lesson
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Has the applicant had previous swimming lessons?
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If yes please describe(*)
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What swimming strokes can the applicant do?
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How far can the applicant swim freestyle?
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Age of child
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Comments
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