DSA Swim Clinic by Coach Leigh Nugent



SWIMMER DETAILS (* required fields)
FULL NAME*
DATE OF BIRTH DAY / MONTH / YEAR
DSA STUDENT ID NO.*
EMAIL ADDRESS*
TRAINING GROUP* Group AGroup BGroup CGroup D
CHOOSE SESSION* Session 1 : Group C & D-Below 13 years old
Session 2 : Group B-Below 13 years old, and Group C & D-13-15 years old
Session 3 : Group A-All age group, and Group B-13 years old and above
PAYMENT RM53 per person needs to be made via bank transfer to
Account Name: D SWIM ACADEMY SDN BHD
Account No. : 564847104977 (Maybank Berhad)

Please attach image of payment slip:
NOTE: Maximum file size per upload is 2 MB. Accepted file formats are .jpg, .gif, .png, .pdf only. Please ensure file names do not contain any special characters (" ' @ # $ ? & etc).

  • All fees paid towards the Swim Clinic are non-refundable
  • Registration for the Swim Clinic is valid for processing only with payment slip image attached as specified above.