Infant Submersion Booking Form – Shrimps @ Redditch

Your Name (required)

Your Child's Name (required)

Child's Date of Birth YYYY-MM-DD(required)

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I would like to book onto an Infant Submersion Shrimp class at Redditch, Feckenham Road, Headless Cross. B97 5AL
Redditch Monday 12:30pm shrimp SarahRedditch Tuesday 2:00pm Shrimp SarahRedditch Friday 10:00am Shrimp Gemma

I am happy for photographs to be taken of my child/ren for use on;
Little Dolphins website YesNo
Promotional material including adverts and banners YesNo