Name of Student (as in NRIC/FIN)(required)
NRIC / FIN No. (required)
Date of Birth(required)
Contact No. (required)
Your Email (required)
Type of Program (required)
---Infant and Toddler AquaticsKids Swimming LessonsAdult Swimming LessonsCPR & AEDLifesaving 1, 2 & 3Bronze Medallion & CPRBronze MedallionAward of Merit & Senior ResuscitationDistinction AwardPool LifeguardSpecial Needs Swimming Program
Current Swimming Abilities or Certificates Attained
Medical Conditions / Allegies / Learning Difficulties / Disabilities
Name of Parent/Guardian (if student is under 21)
Parent/Guardian's Contact No.
How Did You Hear About Us (required)
Search Engine (e.g. Google, Yahoo!, Bing)FacebookEcommerce Marketplace (e.g. Groupon, Ensogo, Streetdeal)RoadshowsWord of mouthSMS TextPrinted Media (e.g. Newspaper, Magazine, Pamphlet)Others
Any Other Comments
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