Cumnor House Registration Form

This pool is suitable for:

Parent & Baby/Toddler
Age 12 months+
Beginners
Development Squads
Adults

Parent’s Name

Parent’s Last Name

Pupil’s Name

Pupil’s Last Name

Telephone Number

Mobile Number (please supply for emergencies)

Address 1

Address 2

Town/City

County

Post Code

Pupil’s Date of Birth

Age

Fitness Swimming Aids

Badges and Certificates

Swimming Ability

Doctor’s Name

Doctor’s Contact Details

Medical Conditions

Free Trial

I’m interested in a Free Trial

Pool Rules

Please ensure you have read the pool rules that may apply.

Photography Consent

Photography is taken by a professional for our own marketing purposes. If you do not want your child’s photo used in any marketing material then please choose No from the dropdown. Read the photography consent terms.

Terms & Conditions

Please tick that you have read and agree to the terms and conditions

Discount Code

Signature

Fees are due at the beginning of each course to secure your place and not refundable if you do not attend the lessons. If you have any other questions please do not hesitate to contact me on 07789552148, 01403 892542 or via the website.

This pool is suitable for:

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