Enrolment

Please fill out this form to provide us with the information we need to proceed with your booking. No payment will need to be made until the booking is finalised and you are happy with the scheduled lessons.

Contact Details

First Name (Adult)
Surname
Address for lessons
Suburb
Phone/Mobile
Email

Participant Details

 
Name
Age
Ability
Participant 1
Participant 2
Participant 3
Participant 4
Participant 5
Participant 6
Please provide details of any medical, physical or intellectual condition that may have a bearing on a person's ability, safety or behaviour in lessons.

Price List (per lesson)

Lesson costs are dependent on number of lessons booked. Participants refers to the total number of people listed on the enrolment form. Lessons 60min and over are a flat fee so costs are shared between participants.

Number of Lessons
Participants
40 Minutes
50 Minutes
60 Minutes
70 Minutes
80 Minutes
Single Trial
Session
1 - 6
$60
N/A
N/A
N/A
N/A
2-7
Sessions
1 - 2
3 - 4
5 - 6
$56
$62
$68
$63
$69
$75
$78
$91
$104
8-13
Sessions
1 - 2
3 - 4
5 - 6
$54
$60
$66
$60
$66
$72
$75
$87
$100
14-20
Sessions
1 - 2
3 - 4
5 - 6
$52
$58
$64
$58
$64
$70
$72
$84
$96

Session Details

Preferred day(s) of the week.
MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Preferred lesson start time
ampm
Select a start date for your lessons. One weeks notice is required from receiving this form for lessons to commence
Number of sessions per week
Select your Session Block
Require something different? Let us know
Would you like individual programme or to be tested for a swim and survive level? See FAQ for more information.
IndividualSwim and Survive*
(*Only applies to bookings of 5 or more lessons.)
Any extra information / questions / requests

Additional Information

How did you hear about us?
A friendWeb SearchCommunity notice boardOther
I have read and accept the terms and conditions. Terms and Conditions