New Enrolments

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Participants Details

Participants Name: Date of Birth: Gender:
1.*
2.
3.
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Preferred Day / Time

Day: Time:  
 
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Responsible Person (Parent / Guardian)

First Name:* Last Name:* Email:*
Phone:* Mobile:* Relationship:*
Street:* Suburb:* Post Code:*
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Medical Information

Do your children suffer from any of the following?

Asthma Diabetes Skin Condition
Hearing Problems Epilepsy Allergies
Vision Problems Learning Difficulties Other
If yes to any of the above, please provide details and/or medical treatment that may be required:
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Emergency Contact (Aside from above)

First Name:* Last Name:* Relationship:*
Phone: Mobile:*  
 
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Terms and Conditions

  1. Make up sessions will be given if 24 hours notice or a doctors certificate is given. Make up sessions will be your responsibility to arrange with the office and will be subject to availability. Make up sessions must be used within the term.
  2. Fees are payable in an upfront or instalment system in advance of lessons. Instalments must be finalised by the 2nd lesson. If payments are not received this may result in the termination of enrolment.
  3. I and if being a minor, my responsible person for and on behalf of myself, consent to activity which is organised, approved or endorsed by Atlantis Aquatic Swim Centre as an activity for me to take part in. My Property and person shall be at my own risk and I will not hold Atlantis Aquatic Swim Centre liable for any personal injury or loss of property which may arise from use of the facility or participants in the activities. I hereby authorise staff at Atlantis Aquatic Swim Centre to organise medical or hospital treatment as they see necessary at my expense.
I Agree to these terms and conditions.