Infant Centre Application
Term 1
29 Aug – 18 Dec 2011 (15 weeks)
Term 2
9 Jan – 8 Apr 2012 (13 weeks)
Term 3
23 Apr – 1 July 2012 (10 weeks)
Child’s Name
Day
Month
Year
Child 1:
DOB:
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
Child 2:
DOB:
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
Febuary
March
April
May
June
July
August
September
October
November
December
Year
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
Child 3:
DOB:
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
Febuary
March
April
May
June
July
August
September
October
November
December
Year
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
Briefly describe your child’s swimming capability i.e. confident, happy, scared, can go under the water etc.
Day/s & time/s that you are available:
Parent’s First Name:
Surname:
Address:
Postcode:
Home Tel *:
Mobile *:
Email *:
* This is important for us to contact you regarding re-enrolments & new term dates
I agree to the
Terms & Conditions
of Bangkok Dolphins as per overleaf.
When signing up for lessons please note this is a term program and payment
is required in full for the course before commencement of lesson.
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