Farnborough Swimming Club

Farnborough Swimming Club - Online Application Form
Date of Applcation

DayMonthYear
Are you applying for Child lessons or Adult lessons?
Full Name of applicant

First NameLast Name
Parent/ Gaurdian's Name
Address

Street Address

Street Address Line 2

CityCounty

Post Code
Date of Birth

DayMonthYear
Telephone Number
Email Address
Swimming Ability

Please choose from the following choices, which best describes your applicants swimming ability
Swimming with Aids/ Without Aids
Swimming Confidence
Last Swimming club (if none, please specify)
Last Badge
Longest distance swum (Meters)
Helping with the swimming club

Please check the following boxes if you are willing to help out with the swimming club.
Would you be willing to help out with the swimming club?
In which area would you be willing to help in?
Medical Information

Please include any medical conditions the applicant has
Medical Information. Please specify any medical conditions (if none, please specifiy)
Doctors Name
Doctors Telephone
Emergency Phone Number
Alternative Phone Number
Enter the message as it's shown
Should be Empty:

Farnborough Swimming Club - Online Application Form