Farnborough Swimming Club

Farnborough Swimming Club - Online Application Form
Date of Applcation*

DayMonthYear
Are you applying for Child lessons or Adult lessons?

Child lessonsadult 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?

YesNo
In which area would you be willing to help in?

PaperworkPoolsideFront DeskTeachingCommittee (6/7 times a year)
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