Junior Courses Enquiry

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*

Email*

Telephone/Mobile*

Select Venue*

Davison Leisure Centre Activities:*

Worthing Leisure Centre Activities:*

Lancing Manor Leisure Centre Activities:*

Southwick Leisure Centre Activities:*

Field Place Manor House & Barns Activities:*

Splashpoint Leisure Centre Activities:*

Wadurs Swimming Pool Activities:*

Prefered Day/Time*

Parents Name*

First Name Surname