New promo registration form

Registration Form

Child's First Name

Child's Birth Date

Child's Allergies or Medical Conditions (Yes or No)

Yes

Child's Last Name

Child' Swimming Experience

Beginner

Immediate

Advance

Kindly state if any physical/mental medical history was experienced (Please give details if any)

Parent's First Name

Parent's Last Name

Parent's Email

Relationship to the child

Mum

Dad

Guardian

Parent's Contact No.

Alternative Email

Singapore Postal Code

Safra Memberhip

Child's Preferred Day of Training

Address 1

I agree to the terms & conditions and the above statementsView terms of use

Your Signature

Thanks for submitting your registration form. See you and you child there!