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Junior Courses Enquiry Form
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Junior Courses Enquiry Form
Childs Details
Childs Name
*
First Name
Surname
Address
*
Street Address
Address Line 2
Town
County
Postcode
Membership number (please state if a non member)
*
Date of Birth
*
Day
Month
Year
Any specific needs or medication we should be aware of?
*
Yes
No
Please let us know of any disabilities/medication or extra support needed
*
Email
*
Telephone/Mobile
*
Select Venue
*
Field Place Manor House & Barns
Southwick Leisure Centre
Splashpoint Leisure Centre
Wadurs Swimming Pool
Worthing Leisure Centre
Worthing Leisure Centre Activities:
*
Athletics (Suitable for 9 - 12 year olds)
Badminton (Suitable for 4 - 16 year olds)
Basketball (Suitable for 7 - 14 year olds)
Gymnastics (Suitable for 5 - 12 year olds)
Trampolining (Suitable for 5 - 16 year olds)
Football (Ages 4 - 15 year olds)
Mini Kickers (2 - 4 year olds)
Junior Dance (4 - 7 year olds)
Field Place Manor House & Barns Activities:
*
Junior Coached Tennis
Southwick Leisure Centre Activities:
*
Junior Coached Tennis
Mini Kickers (2 - 4 year olds)
Tennis Tots (Walking up to 5 years old)
Splashpoint Leisure Centre Activities:
*
Weekly Swimming Lessons
Intensive Swimming Lessons
Rookies
Junior Swim Coaching
Aqua Baby
Aqua Tots
Aqua Splash
Wadurs Swimming Pool Activities:
*
Weekly Swimming Lessons
Intensive Swimming Lessons
Prefered Day/Time
*
Parent/Carer's Details
Parents Name
*
First Name
Surname
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