Name: ______________________________
Address: ______________________________________
Telephone/Emergency Contact: _____________________
Child’s Name: _________________________
Date of Birth: ____________________
Sex: Male/Female.
I wish to enrol my child for swimming lessons.
I enclose – PLEASE TICK AMOUNT PAID £10 ____ (this is a non-refundable DEPOSIT) £42 ___ (half term) or £78 ___ (full-term)
Please make cheques payable to DJR Swim School.
(Cheques can be post-dated to the first Monday of the new term – See calendar page for term dates.)
Signed: ___________________ Date: ______________
Address: ______________________________________
Telephone/Emergency Contact: _____________________
Child’s Name: _________________________
Date of Birth: ____________________
Sex: Male/Female.
I wish to enrol my child for swimming lessons.
I enclose – PLEASE TICK AMOUNT PAID £10 ____ (this is a non-
(Cheques can be post-
Signed: ___________________ Date: ______________
Before completing and sending deposits, please contact us for waiting list times by using the following link: david.robinson@talktalk.net
