Registration | Just Like Fish Swim School

Registration

Registration
  • Today's Date*make a booking
    0
  • Parent / Guardian Name*
    1
  • Address*
    2
  • Home Number*
    3
  • Work Number*full name
    4
  • Mobile Number*full name
    5
  • Email Address*full name
    6
  • Where did you hear about us?*full name
    7
  • Child Details
    8
  • How many children would you like to register?
    9
  • How many children do you have*select number of children
    10
  • Child 1 Name*full name
    11
  • Child's Gender
    12
  • Gender*select just one
    Male
    Female
    13
  • Date of Birth*full name
    14
  • What school or preschool does your child attend?*full name
    15
  • Has your child had lessons previously?
    16
  • Has your child had lessons previously?*
    Yes
    No
    17
  • If so, where?*full name
    18
  • Why did you leave?*full name
    19
  • Medical / Emergency Contact
    47
  • Are there any learning difficulties or medical conditions we should know about?
    48
  • If yes please explain*something more
    49
  • Doctor's Name*full name
    50
  • Doctor's Phone Number*full name
    51
  • Emergency Contact Person*full name
    52
  • Relationship to Student*full name
    53
  • Emergency Contact Numbers*full name
    54
  • Privacy Agreement
    55
  • I have read the Privacy Agreement
    56
  • Hobbies*select one or more
    Yes
    No
    57
  • 58
  • Email*a valid email address
    59
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