Ezyswim Home Page Mosman Swim Centre Bankstown Swim Centre North Rocks Swim Centre
Members with Private Health Insurance may be eligible to claim for a rebate for swimming tuition form their insurer. If you require a receipt from us for these purposes, please complete form below and we will mail this to you within 7 days.
Venue*:
Surname:*
Member First Name:
Name #1*:
Name #2:
Name #3:
Member Number: (if known)
Member #1 :
Member #2:
Member #3:
E-Mail*:
Address:
Contact Numbers:
Home Phone:
Work Phone:
Mobile Phone:
Day/s & Time/s of Class/es:
Day #1*:
Class Time #1*:
Day #2:
Class Time #2:
Day #3:
Class Time #3:
Period of Receipt Required:
Date of First Lesson:
Date of Final Lesson:
Security code:
security code