Registration form
1. Berliner Kinder - Schwimmschule Plantagenstraße 2 12169 Berlin (Steglitz) Swimming course	Tel. 030 - 791 234 4 Fax 030 - 793 23 07 Sample hour / trial hour

Last name:*

Forename:*

Street:*

Post code / Town:*

Telephone:

Telephone / Mobile:

e - mail

Swimming class of desire dates:
Hereby I apply for myself to one
Adult course   15 x 30 min.  EURO 280,-
Please select Mo 12.00 - 12.30 h Mo 12.30 - 13.00 h Mo 13.00 - 13.30 h Mo 13.30 - 14.00 h ------------------- Mo 18.30 - 19.00 h Mo 19.00 - 19.30 h Mo 19.30 - 20.00 h Mo 20.00 - 20.30 h Mo 20.30 - 21.00 h Mo 21.00 - 21.30 h Mo 21.30 - 22.00 h ------------------------------- Tu 12.00 - 12.30 h Tu 12.30 - 13.00 h Tu 13.00 - 13.30 h Tu 13.30 - 14.00 h ------------------- Tu 18.30 - 19.00 h Tu 19.00 - 19.30 h Tu 19.30 - 20.00 h Tu 20.00 - 20.30 h Tu 20.30 - 21.00 h Tu 21.00 - 21.30 h Tu 21.30 - 22.00 h ------------------------------- We 12.00 - 12.30 h We 12.30 - 13.00 h We 13.00 - 13.30 h We 13.30 - 14.00 h ------------------- We 18.30 - 19.00 h We 19.00 - 19.30 h We 19.30 - 20.00 h We 20.00 - 20.30 h We 20.30 - 21.00 h We 21.00 - 21.30 h We 21.30 - 22.00 h ------------------------------- Th 12.00 - 12.30 h Th 12.30 - 13.00 h Th 13.00 - 13.30 h Th 13.30 - 14.00 h ------------------- Th 18.30 - 19.00 h Th 19.00 - 19.30 h Th 19.30 - 20.00 h Th 20.00 - 20.30 h Th 20.30 - 21.00 h Th 21.00 - 21.30 h Th 21.30 - 22.00 h ------------------------------- Fr 12.00 - 12.30 h Fr 12.30 - 13.00 h Fr 13.00 - 13.30 h Fr 13.30 - 14.00 h ------------------- Fr 18.30 - 19.00 h Fr 19.00 - 19.30 h Fr 19.30 - 20.00 h Fr 20.00 - 20.30 h Fr 20.30 - 21.00 h Fr 21.00 - 21.30 h Fr 21.30 - 22.00 h ------------------------------- or and Please select Mo 12.00 - 12.30 h Mo 12.30 - 13.00 h Mo 13.00 - 13.30 h Mo 13.30 - 14.00 h ------------------- Mo 18.30 - 19.00 h Mo 19.00 - 19.30 h Mo 19.30 - 20.00 h Mo 20.00 - 20.30 h Mo 20.30 - 21.00 h Mo 21.00 - 21.30 h Mo 21.30 - 22.00 h ------------------------------- Tu 12.00 - 12.30 h Tu 12.30 - 13.00 h Tu 13.00 - 13.30 h Tu 13.30 - 14.00 h ------------------- Tu 18.30 - 19.00 h Tu 19.00 - 19.30 h Tu 19.30 - 20.00 h Tu 20.00 - 20.30 h Tu 20.30 - 21.00 h Tu 21.00 - 21.30 h Tu 21.30 - 22.00 h ------------------------------- We 12.00 - 12.30 h We 12.30 - 13.00 h We 13.00 - 13.30 h We 13.30 - 14.00 h ------------------- We 18.30 - 19.00 h We 19.00 - 19.30 h We 19.30 - 20.00 h We 20.00 - 20.30 h We 20.30 - 21.00 h We 21.00 - 21.30 h We 21.30 - 22.00 h ------------------------------- Th 12.00 - 12.30 h Th 12.30 - 13.00 h Th 13.00 - 13.30 h Th 13.30 - 14.00 h ------------------- Th 18.30 - 19.00 h Th 19.00 - 19.30 h Th 19.30 - 20.00 h Th 20.00 - 20.30 h Th 20.30 - 21.00 h Th 21.00 - 21.30 h Th 21.30 - 22.00 h ------------------------------- Fr 12.00 - 12.30 h Fr 12.30 - 13.00 h Fr 13.00 - 13.30 h Fr 13.30 - 14.00 h ------------------- Fr 18.30 - 19.00 h Fr 19.00 - 19.30 h Fr 19.30 - 20.00 h Fr 20.00 - 20.30 h Fr 20.30 - 21.00 h Fr 21.00 - 21.30 h Fr 21.30 - 22.00 h

my child to one
Baby course   20 x 30 min.  EURO 225,-
Please select Mo 09.00 - 09.30 h Mo 09.30 - 10.00 h Mo 10.00 - 10.30 h Mo 10.30 - 11.00 h Mo 11.00 - 11.30 h Mo 11.30 - 12.00 h Mo 12.00 - 12.30 h Mo 12.30 - 13.00 h ------------------- Mo 17.00 - 17.30 h Mo 17.30 - 18.00 h ------------------------------- Tu 09.00 - 09.30 h Tu 09.30 - 10.00 h Tu 10.00 - 10.30 h Tu 10.30 - 11.00 h Tu 11.00 - 11.30 h Tu 11.30 - 12.00 h Tu 12.00 - 12.30 h Tu 12.30 - 13.00 h ------------------- Tu 17.00 - 17.30 h Tu 17.30 - 18.00 h ------------------------------- We 09.00 - 09.30 h We 09.30 - 10.00 h We 10.00 - 10.30 h We 10.30 - 11.00 h We 11.00 - 11.30 h We 11.30 - 12.00 h We 12.00 - 12.30 h We 12.30 - 13.00 h ------------------------------- Th 09.00 - 09.30 h Th 09.30 - 10.00 h Th 10.00 - 10.30 h Th 10.30 - 11.00 h Th 11.00 - 11.30 h Th 11.30 - 12.00 h Th 12.00 - 12.30 h Th 12.30 - 13.00 h ------------------- Th 17.00 - 17.30 h Th 17.30 - 18.00 h ------------------------------- Fr 09.00 - 09.30 h Fr 09.30 - 10.00 h Fr 10.00 - 10.30 h Fr 10.30 - 11.00 h Fr 11.00 - 11.30 h Fr 11.30 - 12.00 h Fr 12.00 - 12.30 h Fr 12.30 - 13.00 h ------------------- Fr 14.00 - 14.30 h Fr 14.30 - 15.00 h ------------------------------- Sa 09.00 - 09.30 h Sa 09.30 - 10.00 h Sa 10.00 - 10.30 h Sa 10.30 - 11.00 h Sa 11.00 - 11.30 h Sa 11.30 - 12.00 h Sa 12.00 - 12.30 h Sa 12.30 - 13.00 h ------------------------------- Su 09.00 - 09.30 h Su 09.30 - 10.00 h Su 10.00 - 10.30 h Su 10.30 - 11.00 h Su 11.00 - 11.30 h Su 11.30 - 12.00 h Su 12.00 - 12.30 h Su 12.30 - 13.00 h ------------------------------- or and Please select Mo 09.00 - 09.30 h Mo 09.30 - 10.00 h Mo 10.00 - 10.30 h Mo 10.30 - 11.00 h Mo 11.00 - 11.30 h Mo 11.30 - 12.00 h Mo 12.00 - 12.30 h Mo 12.30 - 13.00 h ------------------- Mo 17.00 - 17.30 h Mo 17.30 - 18.00 h ------------------------------- Tu 09.00 - 09.30 h Tu 09.30 - 10.00 h Tu 10.00 - 10.30 h Tu 10.30 - 11.00 h Tu 11.00 - 11.30 h Tu 11.30 - 12.00 h Tu 12.00 - 12.30 h Tu 12.30 - 13.00 h ------------------- Tu 17.00 - 17.30 h Tu 17.30 - 18.00 h ------------------------------- We 09.00 - 09.30 h We 09.30 - 10.00 h We 10.00 - 10.30 h We 10.30 - 11.00 h We 11.00 - 11.30 h We 11.30 - 12.00 h We 12.00 - 12.30 h We 12.30 - 13.00 h ------------------------------- Th 09.00 - 09.30 h Th 09.30 - 10.00 h Th 10.00 - 10.30 h Th 10.30 - 11.00 h Th 11.00 - 11.30 h Th 11.30 - 12.00 h Th 12.00 - 12.30 h Th 12.30 - 13.00 h ------------------- Th 17.00 - 17.30 h Th 17.30 - 18.00 h ------------------------------- Fr 09.00 - 09.30 h Fr 09.30 - 10.00 h Fr 10.00 - 10.30 h Fr 10.30 - 11.00 h Fr 11.00 - 11.30 h Fr 11.30 - 12.00 h Fr 12.00 - 12.30 h Fr 12.30 - 13.00 h ------------------- Fr 14.00 - 14.30 h Fr 14.30 - 15.00 h ------------------------------- Sa 09.00 - 09.30 h Sa 09.30 - 10.00 h Sa 10.00 - 10.30 h Sa 10.30 - 11.00 h Sa 11.00 - 11.30 h Sa 11.30 - 12.00 h Sa 12.00 - 12.30 h Sa 12.30 - 13.00 h ------------------------------- Su 09.00 - 09.30 h Su 09.30 - 10.00 h Su 10.00 - 10.30 h Su 10.30 - 11.00 h Su 11.00 - 11.30 h Su 11.30 - 12.00 h Su 12.00 - 12.30 h Su 12.30 - 13.00 h -------------------------------
Infant course (large babies)   20 x 30 min.  EURO 225,-
Please select Mo 12.00 - 12.30 h Mo 17.30 - 18.00 h ------------------------------- We 09.00 - 09.30 h ------------------------------- Fr 15.00 - 15.30 h ------------------------------- Sa 16.15 - 16.45 h Sa 16.45 - 17.15 h ------------------------------- Sunday 13.30 h Sunday 15.30 h or and Please select Mo 12.00 - 12.30 h Mo 17.30 - 18.00 h ------------------------------- We 09.00 - 09.30 h ------------------------------- Fr 15.00 - 15.30 h ------------------------------- Sa 16.15 - 16.45 h Sa 16.45 - 17.15 h ------------------------------- Sunday 13.30 h Sunday 15.30 h
Child course   17 x 45 min.  EURO 240,-
*(with parents)
Please select Mo 14.00 - 14.45 h Mo 14.45 - 15.30 h Mo 15.30 - 16.15 h Mo 16.15 - 17.00 h Mo 17.00 - 17.45 h Mo 17.45 - 18.30 h ------------------------------- Tu 14.00 - 14.45 h Tu 14.45 - 15.30 h Tu 15.30 - 16.15 h Tu 16.15 - 17.00 h Tu 17.00 - 17.45 h Tu 17.45 - 18.30 h ------------------------------- We 14.00 - 14.45 h We 14.45 - 15.30 h We 15.30 - 16.15 h We 16.15 - 17.00 h We 17.00 - 17.45 h We 17.45 - 18.30 h ------------------------------- Th 14.00 - 14.45 h Th 14.45 - 15.30 h Th 15.30 - 16.15 h Th 16.15 - 17.00 h Th 17.00 - 17.45 h Th 17.45 - 18.30 h ------------------------------- Fr 14.00 - 14.45 h Fr 14.45 - 15.30 h Fr 15.30 - 16.15 h Fr 16.15 - 17.00 h Fr 17.00 - 17.45 h Fr 17.45 - 18.30 h ------------------------------- Sa 09.30 - 10.15 h * Sa 10.15 - 11.00 h * Sa 12.30 - 13.15 h * Sa 14.00 - 14.45 h Sa 14.45 - 15.30 h Sa 15.30 - 16.15 h Sa 16.15 - 17.00 h Sa 17.00 - 17.45 h Sa 17.45 - 18.30 h ------------------------------- Su 14.00 - 14.45 h Su 14.45 - 15.30 h Su 15.30 - 16.15 h Su 16.15 - 17.00 h Su 17.00 - 17.45 h Su 17.45 - 18.30 h ------------------------------- or and Please select Mo 14.00 - 14.45 h Mo 14.45 - 15.30 h Mo 15.30 - 16.15 h Mo 16.15 - 17.00 h Mo 17.00 - 17.45 h Mo 17.45 - 18.30 h ------------------------------- Tu 14.00 - 14.45 h Tu 14.45 - 15.30 h Tu 15.30 - 16.15 h Tu 16.15 - 17.00 h Tu 17.00 - 17.45 h Tu 17.45 - 18.30 h ------------------------------- We 14.00 - 14.45 h We 14.45 - 15.30 h We 15.30 - 16.15 h We 16.15 - 17.00 h We 17.00 - 17.45 h We 17.45 - 18.30 h ------------------------------- Th 14.00 - 14.45 h Th 14.45 - 15.30 h Th 15.30 - 16.15 h Th 16.15 - 17.00 h Th 17.00 - 17.45 h Th 17.45 - 18.30 h ------------------------------- Fr 14.00 - 14.45 h Fr 14.45 - 15.30 h Fr 15.30 - 16.15 h Fr 16.15 - 17.00 h Fr 17.00 - 17.45 h Fr 17.45 - 18.30 h ------------------------------- Sa 09.30 - 10.15 h * Sa 10.15 - 11.00 h * Sa 12.30 - 13.15 h * Sa 14.00 - 14.45 h Sa 14.45 - 15.30 h Sa 15.30 - 16.15 h Sa 16.15 - 17.00 h Sa 17.00 - 17.45 h Sa 17.45 - 18.30 h ------------------------------- Su 14.00 - 14.45 h Su 14.45 - 15.30 h Su 15.30 - 16.15 h Su 16.15 - 17.00 h Su 17.00 - 17.45 h Su 17.45 - 18.30 h -------------------------------

Name of Trainee:

Date of birth:

Beginning of course:

• Please do not post the dates fewer than 3 days in advance, so that we can recall you still in time for acknowledgement.
• We will acknowledge a date desire by telephone / by fax or e-mail.
• Please agreed upon dates always keep, or in time - at least 1 day beforehand - call off.
• If you are hindered in an emergency case, please give us a call (mailbox).
• In the case, your requirement is lost to a punctual reject on this period, but you have to select the possibility another date.

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Comment:

Sample hour / trial hour: