Name of Parent

Contact No.

Age of Student

Location of Teaching Venue

Preferred Day Preferred Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Preferred Timing Preferred Timing Early Morning 7 - 9am Late Morning 9 - 12pm Early Afternoon 12 - 3pm Late Afternoon 3 - 6pm Evening 6 - 8pm Night 8 - 10pm

Starting Date

Proficiency ProficiencyUnable to SwimKnows Basic StrokeKnows Advance StrokeCompetitive

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Additional Information