0645736001
AQUA 020

Kids registration form

After completing this form, you will receive a payment link for the €35 registration fee. Once the payment has been made, your registration will be confirmed and swimming lessons can begin.
Gender
Male
Female
Other
First name of the student Last name of the student Date of birth
You are registering for:
Swimming age 4+ - Diploma A
Swimming age 4+ - Diploma B en C
Lesson preference – we will take your preference into account as much as possible.*
17.15 - 17.55 (KIDS)
17.55 - 18.35 (KIDS)
18.00 - 19.00 (ADVANCE)
Phone number Emergency contact phone number E-mail Home adress Account number (IBAN) Account holder’s name For the safety and well-being of our members, we kindly ask whether there are any medical or physical conditions that the swimming instructor should be aware of. This may include allergies, chronic conditions, or any other issues that could affect participation and/or safety. I agree to the Algemene voorwaarden en het Privacybeleid Complete registration