CCGS Learn to swim/Fast and Fit Squad enrolment

Please note fields marked with (*) are required.
Location(*)
Please select the location for the lessons in which you wish to enrol.

Claremont lesson price DOES NOT include pool entry and this must be paid separately to Claremont pool at entry.

Term Dates: Mon Oct 9th - Sat Dec 9th

Enrolment Information

Surname(*)
Please enter your Surname

Parent Name(*)
Please type your full name.

Address(*)
Please include your address

Suburb(*)
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Post Code(*)
Please include your post code

Mobile Phone(*)
Please include your mobile phone number

Email(*)
Please include your email address

Emergency Contact(*)
Please enter the name of an Emergency Contact

Phone No(*)
Please enter the phone number for the Emergency Contact

Medical Conditions
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Notes for Enrolment
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Swimmer 1 Details

Enter the details and lesson preferences for your first swimmer on this page. After completing the details and lesson request fields below, subsequent swimmers can be added by clicking the Add Another Swimmer button below.

If this is the only swimmer you wish to enrol, please click the Skip to Payment button after completing the fields below.

Name(*)
Please include Swimmer 1 Name

Level
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DOB
Invalid Date of Birth for Swimmer 1

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Lesson Request

Please provide TWO lesson day & time preferences for this swimmer.

Day (1st Preference)
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Time (1st Preference)
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Day (2nd Preference)
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Time (2nd Preference)
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Swimmer 2 Details

Enter the details and lesson preferences for your second swimmer on this page. After completing the details and lesson request below, a third swimmer can be added by clicking the Add Another Swimmer button below.

If this is the last swimmer you wish to enrol, please click the Skip to Payment button after completing the fields below.

Name

Level
Invalid Input

DOB
Invalid Date of Birth for Swimmer 2

Invalid Input

Lesson Request

Please provide TWO lesson day & time preferences for this swimmer.

Day (1st Preference)
Invalid Input

Time (1st Preference)
Invalid Input

Day (2nd Preference)
Invalid Input

Time (2nd Preference)
Invalid Input

 

Swimmer 3 Details

Enter the details and lesson preferences for your third swimmer on this page.

Once complete, please click the payment button.

Name

Level
Invalid Input

DOB
Invalid Date of Birth for Swimmer 3

Invalid Input

Comments
Invalid Input

Lesson Request

Please provide TWO lesson day & time preferences for this swimmer.

Day (1st Preference)
Invalid Input

Time (1st Preference)
Invalid Input

Day (2nd Preference)
Invalid Input

Time (2nd Preference)
Invalid Input

 

Payment Details

Please note, we only accept Visa and MasterCard for credit card payments. Your payment will not be processed until your booking is confirmed by Kirby Swim.
A 5% discount is available to current Christ Church Grammar School families.

CCGS Discount
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Credit Card #
Visa or MC ONLY(*)
Please enter a valid Credit Card number

Expiry Date(*)
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Amount
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Terms & Conditions(*)
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I agree to the Kirby Swim Terms & Conditions