Skip to content
Home
About
Information Pack
Terms & Conditions
Contact
Enrollment
Enrollment
Main Menu
Home
About
Contact
Information Pack
Terms & Conditions
Enrollment
Enrollment
Number Of Swimmers
1 Swimmer
2 Swimmers
3 Swimmers
4 Swimmers
5 Swimmers
STUDENT/SWIMMER 1 SURNAME
*
STUDENT/SWIMMER 1 FIRST NAME
*
STUDENT/SWIMMER 2 SURNAME
*
STUDENT/SWIMMER 2 FIRST NAME
*
STUDENT/SWIMMER 3 SURNAME
*
STUDENT/SWIMMER 3 FIRST NAME
*
STUDENT/SWIMMER 4 SURNAME
*
STUDENT/SWIMMER 4 FIRST NAME
*
STUDENT/SWIMMER 5 SURNAME
*
STUDENT/SWIMMER 5 FIRST NAME
*
DATE OF BIRTH
*
DATE OF BIRTH 2
*
DATE OF BIRTH 3
*
DATE OF BIRTH 4
*
DATE OF BIRTH 5
*
PARENTS NAME 1
PARENTS NAME 2
ADDRESS
*
EMAIL ADDRESS
*
TEL HOME
TEL HOME
TEL WORK
TEL WORK
CELL
CELL
DOES THE STUDENT/S SUFFER FROM ANY (PLEASE SPECIFY)
CHEST AILMENTS
*
YES
NO
PLEASE SPECIFY
PHYSICAL INJURIES
*
YES
NO
PLEASE SPECIFY
EAR AILMENTS
*
YES
NO
PLEASE SPECIFY
ALLERGIES
*
YES
NO
PLEASE SPECIFY
ANY ADDITIONAL MEDICAL INFORMATION (Surgery, Mental/Physical Impairment, Illness…)
INDEMNITY
I HEREBY WAIVE ANY CLAIM WHICH I MAY HAVE AGAINST iSWIM OR ANY OF THEIR EMPLOYEES FOR ANY DAMAGE SUSTAINED BY ANY PERSON WHICH MAY ARISE IN CONNECTION WITH THE SWIM SCHOOL WHETHER SUCH DAMAGE ARISES AS A RESULT OF THEFT, LOSS OF LIFE, BODILY INJURY OR ANY CAUSE WHATSOEVER.
I HAVE READ AND AGREE TO THE TERMS AND CONDITIONS STATED ON THE WEBSITE
SUBMIT
