Name:

Phone Number:

Email:

Address:

Unit #:

Postal Code:

Gender: Male                Female

Locations Bedok Swimming Complex Bishan Swimming Complex Bukit Batok Swimming Complex Buona Vista Swimming Complex Chao Chu Kang Swimming Complex Clementi Swimming Complex Delta Swimming Complex Hougang Swimming Complex Geylang East Swimming Complex Jurong West Swimming Complex Kallang Basin Swimming Complex Sengkang Swimming Complex Tampines Swimming Complex Toa Payoh Swimming Complex Woodlands Swimming Complex Yio Chu Kang Swimming Complex Yishun Swimming Complex

Num of student: One Two Three Four

Level: Beginner Intermediate Advance

Name( student 1):

 DOB(Student 1):

Gender (Student 1): Male                Female

Name (Student 2):

D.O.B (Student 2):  

Gender (Student 2): Male                Female

Name (Student 3):

D.O.B (Student 3):  

Gender (Student 3): Male                Female

Name (Student 4):

D.O.B (Student 4):  

Gender (Student 4): Male                Female

Remark:

1 + 2 + 5 =

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