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Parent First Name
*
Parent Last Name
*
Parent Date of birth
*
Year
/
Month
/
Day
Mobile phone number
*
Email
*
Number of children you're enquiring
*
Please Select
1
2
3
Child 1 First Name
*
Child 1 Last Name
*
Child 1 Date of Birth
*
Day
/
Month
/
Year
Child 1 Gender
Male
Female
Other
Child 2 First Name
Child 2 Last Name
Child 2 Date of Birth
Day
/
Month
/
Year
Child 2 Gender
Male
Female
Other
Child 3 First Name
Child 3 Last Name
Child 3 Date of Birth
Day
/
Month
/
Year
Child 3 Gender
Male
Female
Other
Recreational Program of Interest*
*
Gym Fun
Gym Skills
Tramp Skills
Teen Skills
Preferred Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Tuesday (Aquatics only)
Thursday (Aquatics only)
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