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New Swimming Pool Registration
Personal Details
Applicant First Name
*
*
Applicant Last Name
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*
Applicant Email
*
*
*
Applicant Mobile
*
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Membership Details
Pool Membership Type
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Single
Child
Family
If Applicable Number of Children
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*
If Applicable Family Members Full Name
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Medical Details
Medical Condition Details
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Emergency Contact Full Name
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*
Emergency Contact Details (Email & Phone)
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*
Consent
Customer/Parent/Guardian Consent
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Additional Details
Additional Notes
*
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