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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?
- Select -
Cheslyn Hay Leisure Centre
Codsall Leisure Centre
Penkridge Leisure Centre
Wombourne Leisure Centre
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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