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britt@aquasharksatlantic.co.za
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facebook
Instagram
britt@aquasharksatlantic.co.za
+27 (0) 82 337 2885
HOME
ABOUT
COACHES
SQUADS
RESOURCES
SHOP ONLINE
TIMETABLE
REGISTER NOW
NEWS
CONTACT
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Swimmer Details
Full Name
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Date of Birth
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Age of Swimmer
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Child (Under 18)
Adult (18+)
Parent / Guardian Details (if child)
Parent / Guardian Full Name
Relationship to swimmer
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Father
Guardian
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Parent / Guardian Contact Number
Parent / Guardian Email Address
Contact Information
Primary Contact Number
Email Address
Alternative Contact Number
Programme Selection
Select Programme / Squad
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Learn to Swim & Stroke (Age 3+)
Bronze Squad (Age 6+)
Silver Squad (Age 8+)
Gold Swim Fit Squad (Age 10+)
Junior Squad (Age 11+)
Senior Squad (Age 12+)
Adult Squads (All ages)
Private Lessons (Adults)
Swimming Ability
Current Swimming Level
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Complete Beginner
Water Confidence
Can Float
Can swim 5 - 10m
Can Swim 25m
Advanced / Squad Level
Preferred Strokes
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Freestyle
Breaststroke
Backstroke
Butterfly
Not sure yet
Medical Information
Emergency Contact Name
Emergency Contact Number
Availability
Preferred Training / Lesson Days
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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Early Morning
Afternoon
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Additional Information
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