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Off the Hoek Swim School
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Swim Levels 1-7
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Off the Hoek Swim School
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Aqua Aerobics Registration
Aqua Aerobics Terms and Conditions
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Swim Levels 1-7
Aqua Aerobics Registration
Please read our Terms and Conditions
HERE
before filling and signing the form below.
Aqua Aerobics Registration
Name
Name
First Name
First Name
Surname
Surname
Date of Birth
ID / Passport Number
Contact Number
Emergency Contact - Name and Number
Email Address
Medical Aid
Number
Can you swim?
Are you fearful of being in water?
CLIENT HEALTH
Which Fitness Level best describes you?
Beginner (I have not exercised in the last year)
Intermediate (I exercise regularly)
Advanced (I enjoy being challenged in class)
Do you have any injuries we need to be aware of?
Do you have any of the following? Please tick if appropriate
Spine Issues
Asthma
Sinus
High Blood Pressure
Low Blood Pressure
Knee Replacement
Hip Replacement
Heart Palpitations (or other regarding the heart)
Which Day would suit you best?
Monday
Wednesday
Friday
PAYMENT - AMOUNT DUE UPON RECEIPT OF INVOICE
Aqua Aerobics Options
R350 for 1 class per week (4 classes per month)
R550 for 2 classes per week (8 classes per month)
Registration Fee
+ 4-week Fee
Total
Send invoice via Whatsapp or email?
I have read and agree to all terms and conditions of this contract.
By checking this box I am signing this contract
Name, Surname and Date of Signing
If you are human, leave this field blank.
Submit
