Swimmers Name

Swim Day booked:
MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Swimmers Date of Birth

Swimmers Medical Conditions

Swimmers Disabilities

Swimmers Special Needs

Parents Name if under 18 ( Main person Bringing child)

Parents / Swimmers Mobile Contact Number

Parents Medical Conditions (If accompanying in the water)

Emergency Contact Number (Must be Different from above)

Home Address:

Your Email

I Agree to the T&C'S, H&S pool rules & agree to follow all Government Covid 19 guidelines and have watched the return to swimming video
I agree