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Centre Drive, Chineham, Basingstoke RG24 8FY

Swim Active Basingstoke Logo
Woman Swimming in Pool

Private Lesson
Swimmer Application Form

Private Lesson – Swimmer Application Form

Swimmers Information

Date of Birth
Day
Month
Year

(E.g. Asthma, Diabetes, Hearing etc.)

Parent / Guardian Information

Relevant only if Swimmer is under 18 years of age.

General Information

Swimmer Assessment

A separate link will be sent for you to sign our Terms & Conditions. Please note Terms & Conditions must be signed before lessons can commence.


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