Adult Enrolment Form

Full name * (required)

Date of birth * (required)

Please list any medical conditions, injuries or specific needs

Contact phone number * (required)

Email address * (required)

Postal address

Is an assessment required ? * (required) Free assessments take place at Moana Pool at a time convenient for you, Monday to Friday 9am - 5pm and Saturday 2pm, 2.15pm, or 2.30pm

Yes
No

Swimmer's details

Contact

Locations