PARENT DETAILS FULL NAME EMAIL ADDRESS CONTACT NO. STUDENT DETAILS FULL NAME DATE OF BIRTH DAY / MONTH / YEAR SELECT PREFERRED LOCATION IMPORTANT: Please select any one of our locations below. Note that programs available and class timings may vary from location to location. Details of more than 1 location entered will invalidate the form. BUKIT JALIL PROGRAM DSA Kiddie Swimmers Program INTAKE Please SelectNovemberDecember TIME Please Select9.00AM9.30AM10.00AM10.30AM11.00AM11.30AM PROGRAM DSA Junior Swimmers Program INTAKE Please SelectNovemberDecember TIME Please Select9.00AM10.00AM11.00AM PANASONIC, SHAH ALAM PROGRAM DSA Junior Swimmers Program INTAKE Please SelectNovemberDecember TIME Please Select9.00AM10.00AM11.00AM KAMPUNG PANDAN PROGRAM DSA Junior Swimmers Program INTAKE Please SelectNovemberDecember TIME Please Select9.00AM10.00AM11.00AM 3K, SUBANG JAYA PROGRAM DSA Junior Swimmers Program INTAKE Please SelectNovemberDecember TIME Please Select12.00PM1.00PM NOTE: Replacement classes are only valid for medical reasons (MC essential), schooling (notice essential) or class cancellation by DSA management. There is strictly no replacement for personal reasons. Girls are allowed strictly only one replacement class due to menstrual cycle during this school holiday program. Replacement lessons have to be arranged at the counter with valid supporting document. Replacement classes will be allocated based on availability. Replacement lessons is only valid till the end of this program. No refunds or prorate of missed classes will be given for any reason. The registration is based on first come first serve basis. Your selection of time slot only serves as a preference and is not guaranteed. You will receive a confirmation call from DSA after a processing period of 30 days (excluding weekends & Mondays) from the date of submission. By submitting this registration form, I, myself or my parent/guardian has fully understood and agreed to follow the rules and regulations set by D Swim Academy Sdn Bhd (750654-V) and I, myself, or as parents/guardian of the student whose name is mentioned above hereby agree to release any and all claims, demands, losses, liabilities, indemnities and hold harmless the maker of any exercises the teachers / coaches / instructors and the companies involved. I verify that all the information given above is true and accurate.