St Mary's War Memorial School West Wyalong eNewsletter

Intensive Swim Lessons - Permission Note

This form is used to give permission for your child to attend the Intensive Swimming at Holland Park Pool, West Wyalong.

Intensive Swimming Program

Our intensive swimming program will be from Monday 30th November to Friday 4th of December.

The P&F have received funding from the Bland Shire Council which will cover half the cost to families.

Families will need to pay $35 per child for the lessons, plus $12.50 for entry per child if you do not have a pool season pass.

Please complete the form below for your family.

Attendance Information

Family Surname *

Child / Children Attendance *

Attending Lessons

NOT Attending Lessons (If you have selected this option please still complete your child's details)

Season Pass Details

Please indicate if you have a Season Pass *

Yes

Student Details

First Child's Name *

First Child's Class *

First Child's Swimming Ability *

Second Child's Name

Second Child's Class

Second Child's Swimming Ability

Third Child's Name

Third Child's Class

Third Child's Swimming Ability

Student Medical Information Update

Student Medical Information (for all of your children)

Nothing has changed since Medical Form returned in Term 1

New / Recent Medical Information below

Additional Medical Information

Parental Consent

Please sign below to give permission for your child/ren to attend the intensive swimming program held at Holland Park Pool in West Wyalong and to agree to pay the discounted cost to the school office.

Payment can be made with cash or EFTPOS at the school office.

Payment Agreement *

I will pay $35 per child - have season pass

I will pay $47.50 per child - NO season pass

Signature of Parent / Guardian *

Undo

Clear

Write your signature above the line