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* 1. Parent First Name

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* 2. Parent Surname

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* 3. Parent Date Of Birth

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* 4. Contact Number

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* 5. Email Address

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* 6. Address

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* 7. Student 1 details

First Name:

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* 8. Surname:

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* 9. Date Of Birth:

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* 10. Medical Information:

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* 11. Comment on your child's swimming ability:

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* 12. Student 2 details

First Name:

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* 13. Surname:

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* 14. Date Of Birth:

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* 15. Medical Information:

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* 16. Comment on your child's swimming ability:

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* 17. Student 3 details

First Name:

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* 18. Surname:

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* 19. Date Of Birth:

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* 20. Medical Information:

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* 21. Comment on your child's swimming ability:

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* 22. Student 4 details

First Name:

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* 23. Surname:

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* 24. Date Of Birth:

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* 25. Medical Information:

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* 26. Comment on your child's swimming ability:

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* 27. Any other comments

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* 28. Preferred Day and Time