Enroll for The Jolly Roger Swim School

To enroll your child or children, please fill out the following form.

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Child's name: Enter Name

Email: Enter Email

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Parents or Guardian's Name: Enter Text

Child's date of birth Enter Text

Home Phone: Enter Text

Cell Phone: Enter Text

Work Phone: Enter Text

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Child's Swimming Experience: Enter Your Message

Are you happy for any photos of your child to be used in our newsletter or added to our Facebook page?: Enter Text

Does your child have any medical or learning conditions?: Enter Your Message

Address

Pembroke Street, Carterton.

Phone

Lynn Wiffen (Mstn) 06 377 3733

Melissa Staines (Ctn) 06 377 2256