Swimming Academy Course Hub Registration Form | South Staffordshire District Council

Accessibility

Current Swimming Academy Course Hub Registration Form
Complete

Indicates required field

Do you already have an account set up with ‘Leisure Hub?

(Due to GDPR, the person completing this form must be the swimming lessons payer.)

Yes

No

If YES, please confirm your membership card number

Which leisure centre do you use for your swimming lessons?

Payers details

Name

Email

Phone

Address

Address 2

Post Code

Please state your DOB

Swimming members details

Name

Email

Phone

Address

Address 2

Post Code

Membership Number (If known)

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