Please enable JavaScript in your browser to complete this form.Child's Full Name *Parent/Guardian Full Name *Child's Date of Birth (MM/DD/YYYY)Your Email *Phone number *Is your child happy/confident in the water? This helps us to place your child in a class. We'll also do an assessment at the start of their first session with us.YesNoWhich days are you NOT available? (Please select all that apply)MondayTuesdayWednesdayThursdayFridaySaturdaySundayPlease note: we do our best to arrange classes to suit as many people as possible, but may not always be able to accommodate your availability.NameSubmit