Learn to Swim ParQ Booking Form 2022

    Personal Details


    Please choose a centre for your lessons:

    Name (Required):

    Surname (Required):

    Leisure Card Number (Required):

    Date of Birth (Required):

    Gender:
    Address (Required):

    Postcode (Required):

    Mobile Number:

    Homephone Number:

    Email (Required):
    This will enable you to log onto the parent portal and access your child’s swimming lesson progress online. Please ask at reception if you require any more information.

    Currently Swims:
    Day:
    Time:
    Wave:

    Emergency Contact / Next of Kin Details

    Full Name (Required):

    Address (Required):

    Postcode (Required):

    Medical Details

    GP Details

    Full Name (Required):

    Address (Required):

    Telephone (Required):

    Medical Conditions

    Please record any medical conditions that may hinder your child’s performance e.g. Asthma.

    Disabilities

    Do you consider your child to have a disability?
    If yes please record your child’s disability below and any additional information you feel we may require.



    Thank you for taking the time to complete the Denbighshire Leisure Learn to Swim ParQ form. Should we require any additional information, we will contact you via the details provided.



    Privacy Statement

    Your personal data will be used by Denbighshire Leisure for the specific purposes of managing your membership, and ensuring your safety whilst on this. We will retain this for the duration of your membership, and for 3 years following the end of your membership. If you feel that we have mishandled your personal data at any time you can make a complaint to the Information Commissioners Office by visiting their website or by calling their helpline on 0303 123 1113. For further information about how Denbighshire Leisure processes personal data and your rights please see our privacy notice on our website – https://denbighshireleisure.co.uk/privacy/

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