PARTICIPANT

Full name*

MaleFemalePrefer not to say

Age *

Medical conditions

PRIME TRAINING PROGRAM ($120):
Thur. 17 Apr ( 6:30-8:00pm )Sat. 19 Apr ( 8:30-10:00am )Thur. 24 Apr ( 6:30-8:00pm )Sat. 26 Apr ( 7:30-9:00am )

ENTRY TRAINING PROGRAM ($60):
Sat. 19 Apr ( 8:30-10:00am )Sat. 26 Apr ( 7:30-9:00am )

Comments:

PARENT / GARDIAN

Full name *

Contact number *

Contact email (for invoices and communication) *

Address

HOW DID YOU HEAR ABOUT CROSSWIM^®: *

I am returning participantSearch engine (e.g. Google)Paper advertising (e.g. flyer)Social media (e.g. Facebook)Word of MouthSignageOther

I confirm, that I and/or my child meet the level's entry requirements

I have read, understand and agree with:
Assumption of risks and waiver/release of liabilityTerms and Conditions of the enrolment

Δ