| Child Forename* |
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Child Surname* |
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| Date Of Birth* |
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| Parent Forename* |
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Parent Surname* |
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| House Name/No & Street* |
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| County* |
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| City* |
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| Postcode* |
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| Daytime Contact Number* |
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| Mobile |
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| Email Address* |
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| Medical Conditions Known |
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| How Did You Here About Aqua Babies |
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| PRELIMINARY 1 COURSE |
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Please select a pool
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| Second Choice |
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Preferred Day*
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Second Choice
(allocated only if your first choice is full)
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| comments |
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| I Agree To The Terms And Conditions* |
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Fee (made payable to Aqua Babies(uk) Ltd) £12.00 per lesson including VAT, paid as a course fee once place is offered . |
Splash About, Happy Nappy £10.00
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