top of page

Home
About
Book a Course
Course Form
Shop
Mermaid Club
Refund Policy
Terms of service
More

Use tab to navigate through the menu items.

SOUTH AFRICA

Book a Mermaid Course

Kindly fill in this form, and we will get in touch regarding course and dates

Email

First name

Last name

Date of Birth

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Emergeny Contact Name

Ergency Contact Number

Thanks for submitting!

Health Declaration

Please fill out the following form
in order to participate in our activity.

First Name

Last Name

Have you been hospitalized in the last 12 months?

No

Yes

Are you suffering from a medical condition, illness, or injury?

No

Yes

Do you have any repiratory conditions?

Yes

No

Do you suffer any Heart Conditions?

Yes

No

If you answered yes to any question, you will need to get a doctors clearance stating you are fit to swim and practice apnea. Please add any details that are important for the instructor to know

Initials

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Whatsapp: 0837909483

Facebook: Moonsong South Africa

Instagram: Moonsong_magic

bottom of page