Adakah anda bersetuju dengan terma dan syarat jomrenang? Sila baca sebelum mendaftar. Terima kasih. / Read TnC before Sign-Up. Rujukan/Ref. http://jomrenang.com/terms/ *
Required
Pilihan Pakej Percubaan dan Ala-Carte
Choice of Trial and Ala-Carte Packages
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Cadangan Tarikh/Hari/Masa untuk mulakan kelas renang./ Suggested Date / Day / Time to start swimming class. *
Your answer
Nama Pelajar / Student's Name *
Your answer
(For more than 1 student, Please write all students name, gender & age)
exp1: Anis/Female/27yo
exp2: Anas/Boy/4yo
Your answer
No. Telefon / HP Number *
Your answer
Umur pelajar/Student's Age *
Your answer
Jantina/Gender *
Please inform if participants have health problems such as diabetes, high blood pressure, cancer, health rehabilitation, pregnancy, autism, skin diseases, allergies, asthma etc. Type "none" if no related. *
Your answer
Penilaian Tahap Kesihatan / Health Scales *
Tidak Sihat/ Not Fit
Cukup Sihat/Fit Enough
Maklumat Ibu/Bapa Penjaga (Parents/Guardian Information)