Learn to Swim and Dive Enquiry Form

First name: (*)Surname: (*)Telephone Number: (*)E-mail: (*)

How should we contact you? (*)Please select a contact preference

E-mailTelephone

Adult or child lessons?(*)Please select a age category

AdultChild

Child's age: (insert n/a if does not apply) (*)Please select the centre you're interested in below (*)Preferred day(s) of the week for swimming / diving lessons (*)Please tell us about your/your child’s swimming experience, if any.By submitting this form, I understand and agree that Active Luton may contact me via email, or phone, for the purpose of delivering their services to me. I understand that Active Luton will not share my information with third parties for the purposes of marketing. For full details about how we use personal data, our legal basis for doing so and your privacy rights, please see our Privacy Policy online.

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Learn to Swim and Dive Enquiry Form