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SQUIDS
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Public Swimming
Emperors Swimming Club
Pool Hire
Sponsor
SQUIDS
Membership
SQUIDS 2024 WAITING LIST
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Parents/Guardians Details
Parent/Guardian 1
*
First
Last
Parent/Guardian 2
First
Last
Street Address
Address Line 1
City
State / Province / Region
Postal Code
Parent/Guardian 1 Phone Number
*
Parent/Guardian 2 Phone Number
Email
*
Email
Confirm Email
Participant Details
Child's Name
*
First
Last
Child's Age
*
Does your child have a health care need that could affect their safety in or near the water?
*
No
Yes
Please specify condition that could affect them and what is needed to help (eg. epipen)
Please supply a copy of any medical action plans required for your child to the Jamestown Swim Club for records
Are you a pool member?
*
Yes - $70.00
No - $105.00
Please purchase a pool membership before enrolling your child to avoid the extra cost. Membership status will be checked and position may be forfeited if false information is received after payment has been submitted.
I agree with the following terms
My child is 5 years or over
I have been truthful with my child's Pool Membership status.
I give consent for my child to participate in swimming/aquatic lessons in the Jamestown Pool
I understand that the instructor may need to help my child physically to ensure my child's safety and learning of the swimming techniques.
Please sign to acknowledge you have read the above
*
Clear Signature
If successfully accepted this will be the cost
$0.00
Submit