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  • Enrol in a course
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Lesson Enrolment Request

Please complete the form below to request manual enrolment into a Swimming Lesson program if the Term has already commenced and website bookings are no longer available.

Once the form has been submitted, our team will contact you to finalise your enrolment.

Enrolment Contact:
Contact First Name must have at least 0 and no more than 256 characters.The value of the Contact First Name field is not valid.
*
Contact Last Name must have at least 0 and no more than 256 characters.The value of the Contact Last Name field is not valid.
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Enter a valid email address.
*
Contact Phone must have at least 0 and no more than 256 characters.The value of the Contact Phone field is not valid.
*
Participant Details:
Participant First Name must have at least 0 and no more than 256 characters.The value of the Participant First Name field is not valid.
*
Participant Last Name must have at least 0 and no more than 256 characters.The value of the Participant Last Name field is not valid.
*
Participant Date of Birth must have at least 0 and no more than 256 characters.The value of the Participant Date of Birth field is not valid.
*
Enter a valid email address.
Mailing Address must have at least 0 and no more than 256 characters.The value of the Mailing Address field is not valid.
*
Emergency Contact Name must have at least 0 and no more than 256 characters.The value of the Emergency Contact Name field is not valid.
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Emergency Contact Phone Number must have at least 0 and no more than 256 characters.The value of the Emergency Contact Phone Number field is not valid.
*
Program Details:
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Program Location (e.g. Cannington, Balga) must have at least 0 and no more than 256 characters.The value of the Program Location (e.g. Cannington, Balga) field is not valid.
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Participant Stage must have at least 0 and no more than 256 characters.The value of the Participant Stage field is not valid.
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Preferred class time (please refer to timetable) must have at least 0 and no more than 256 characters.The value of the Preferred class time (please refer to timetable) field is not valid.
*

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