PD OPEN WATER SWIM CLINIC 2025 REGISTRATION

Contact UNDER of

Swimmer's Full Name: *

Date of Birth (DD/MM/YYYY): *

Age: *

Guardian's Full Name: *

Relationship to Swimmer: *

Guardian's Contact Number: *

Guardian's Email Address: *

Consent (FOR SWIMMERS UNDER 18) *

I, the undersigned guardian, give permission for the above-named swimmer to participate in the Open Water Swim Clinic at Port Dickson on 4th January 2025.

*SAFETY BUOY IS COMPULSORY

Safety Buoy