Wufoo
AquaDolf Swimming Pre-Registration Form
Field with (*) is compulsory. Fill in with your complete and correct details. SCROLL DOWN to see the SUBMIT/SEND button.
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Thank you
Name
*
Email
*
Phone Number:
*
Maximum Allowed:
10
digits.
Currently Used:
0
digits.
Class Venue
*
PJ Private Pool (for Ladies Only)
Your own pool (Weekdays, Limited Slots)
Your Location (for those who chose Own Private Pool in the previous question)
Choose your class/enquiries
*
Select Your Option
1 on 1: 8 lessons
1 on 1:12 lessons
1 on 2: 8 lessons
1 on 2: 12 lessons
Kids Class (7-12 years)
Small Group Class (max 4, own group)
Group Class for Company/Clubs/School/IPT
Stroke Analysis Class
Lifesaving Courses (Bronze, ILS)
CPR & First Aid Course
Scuba Diving Course
Dive and Snorkelling Trip
Day(s) of choice? Maximum Twice per week
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Time Slot preferred?(1 hour per session)
Morning: between 10.00 - 1.00
Afternoon: between 3.00 to 5.00
Evening: between 6.00 to 10.00
Payment Preference
*
By Cash
By Bank Transfer
By Credit Cards
When can you start the lesson and other enquiries
Do Not Fill This Out
