Register for National Learn To Swim Week 2020

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First Name (Learner) *

Last Name (Learner) *

First Name (Parent/Guardian if Learner is under 18) *

Last Name (Parent/Guardian if Learner is under 18) *

Age of Learner *

MUST be 6 years or older. Type "adult" if over the age of 18

Contact Number 1 *

Contact Number 2

Email Address

Beach Location *

Please choose your preferred location for the classes

Time *

Please choose your preferred class time

Submit

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