Child Name:*

Date of Birth*

Date to Attend Come & Try (Please select one option):*

How did you hear about Aqualina?* Max. 255 characters

I confirm my child is a confident, competent and water safe swimmer, who has the ability able to swim at least 25 meters independently in a deep pool*

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.**

I agree to the Terms of Registration (published on myAqualina.org.au/registration/terms*

Parent Name* Max. 255 characters

Parent Contact Number* Max. 255 characters

Parent Email Address* Max. 255 characters

Do you have any questions or additional comments? Max. 255 characters

Come & Try participants are also required to register with Artistic Swimming Australia. Please complete the registration form for your child to become a Come & Try member with Artistic Swimming Australia at https://www.myaqualina.org.au/registration*

I confirm that I have registered my child as a Come & Try member with Artistic Swimming Australia and provided the required details.*