Forename(required) Surname(required) Title Date of Birth(required) House Name/No(required) Street(required) Town/City(required) Postcode(required) Contact Number Email Address(required) Are you applying on behalf of a child? No Yes Child's Forename Child's Surname Child's Date of Birth Adult Swimming Courses Adult Non Swimmer Adult Improver One to One Lessons Children's Swimming Courses Child Beginner Child Improver One to One Lessons Medical conditions that coaching staff need to be aware of: Leisure Centre - Please Indicate 1st choice pool. Buckley Leisure Centre Jade Jones Pavilion Flint Mold Leisure Centre Leisure Centre - Please Indicate 2nd choice pool. Buckley Leisure Centre Jade Jones Pavilion Flint Mold Leisure Centre Submit Cliciwch yma i weld y dudalen hon yn Gymraeg Share this:TwitterFacebookLike this:Like Loading...