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Ollie Otter's Swim
School |
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APPLICATION FORM. |
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Please tick box next to
venue required. |
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CARWARDEN |
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GORDONS |
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CRASH
COURSE |
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FULL
NAME
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AGE
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D.O.B
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ADDRESS
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..POSTCODE
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TEL
NO
E-MAIL ADDRESS
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EMERGENCY
NUMBER
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NAME OF
SCHOOL
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ANY KNOWN
MEDICAL CONDITIONS
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ANY SPECIAL
NEEDS
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DOES
YOUR CHILD HOLD ANY CURRENT SWIMMING CERTIFICATES. PLEASE GIVE |
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DETAILS AND
WHERE ATTAINED
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HOW FAR CAN YOUR CHILD SWIM. PLEASE
TICK BELOW. |
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Non Swimmer |
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5m |
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10m |
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15m |
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UNDER 25M |
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OVER 25M |
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OVER
50M |
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OVER 100M |
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The
swim school can only accept responsibility for any person in lessons with a
teacher. The safety of others is the responsibility of a parent or guardian.
All children must be accompanied by an adult whilst on poolside. |
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PARENT OR
GUARDIAN SIGNATURE
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DATE:
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CHEQUES
MADE PAYABLE TO OLLIE OTTER'S Ltd. PLEASE SEND FULL PAYMENT TO:
20 Five Oaks Close,St Johns, Woking, Surrey, GU21 8TU. Places are allocated
on a first come first served basis and cannot be guaranteed until full
payment is received.
Please note that bookings will be non-refundable and non-transferable (i.e.
from one term to another or one person to another) once confirmation has been
received by us. |
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OFFICE USE ONLY |
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TIME OF
LESSON
..(CODE
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