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Swimming Lesson -Form Fill
Section One
Q1
Participant name
First Name
Q2
Participant name
Last Name
Q3
Phone number
Q4
Email
Q5
Birth date
Date
Q6
Gender
Q7
Session beginning date and time
Date
Q8
Session beginning date and time
Hour Minutes
Q9
Do you have any health issues that we should be aware of?
Q10
Your health condition report provided by your doctor
Q11
By signing below I agree the following
Q12
Your signature
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