Enrolment Form

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ENROLMENT FORM

Enrolment Form
Please fill in the details on this form if you are a new student booking or a returning student booking. By choosing "Submit" you are agreeing to the Terms and Conditions of Paragon Swim Centre Pty Ltd.

* Indicates required field

Student Name *

First

Last

Age *

Swimmers date of birth

Date of Birth *

Gender *

Male Female

Primary Contact Name *

First

Last

Relationship to Child *

Address *

Suburb *

State *

Post Code *

Telephone *

Email *

Medical Information *

ADD/ADHD Asthma Autism Developmental Delays Diabetes Ear Disorder Epilepsy Eye Disorder Fainting Spells Heart Condition Learning Support Needs Low Muscle Tone Speech/Language Delay Other Behavioural Issues

Please tick what medical information the child/adult has

Any other relevant medical information *

Submit

Address:
Paragon Swim Centre
97-99 Smart Rd
Modbury, South Australia, 5092
Tel: 08 8396 6978
E: paragonswim@gmail.com
W: www.paragonswim.com.au

Trading Hours
Monday to Thursday 6am – 8:30pm
Friday 6am – 8pm
Saturday 6.30am – 2pm
Sunday 7.30 – 2pm

Paragon Swim Centre
97-99 Smart Rd
Modbury, South Australia, 5092
Tel: 08 8396 6978
E: paragonswim@gmail.com
W: www.paragonswim.com.au

Trading Hours
Monday to Thursday 6am – 8:30pm
Friday 6am – 8pm
Saturday 6:30am – 2pm
Sunday 7:30am – 2pm
Closed on Public Holidays

Enrolment Form

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Home
Swim Programs
About
- About Us
- FAQ's
Holiday Programs
Public Swimming
Contact
- Contact Us
- Absentee Form
Fitness

ENROLMENT FORM

Enrolment FormPlease fill in the details on this form if you are a new student booking or a returning student booking. By choosing "Submit" you are agreeing to the Terms and Conditions of Paragon Swim Centre Pty Ltd.​

Enrolment Form
Please fill in the details on this form if you are a new student booking or a returning student booking. By choosing "Submit" you are agreeing to the Terms and Conditions of Paragon Swim Centre Pty Ltd.