logo Southside Aquatics Registration Form

Swimmers Name
Parents name/s
Home Contact Number
Work Contact Number
Mobile Contact Number
School Attended

Medical Consideration:
It is our professional duty of care to ask all participants, no matter what age, to complete the following questions.

Is your child currently being treated for any medical condition
Is your child on any prescribed medication  
Does your child suffer from       

If you ticked yes please give details of conditions, medications and approximate date cleared.

Has your child ever had swimming lessons before
If yes when did these lessons start
When was the last lesson
Please tell us how you found out about our swim program
Does your child have any fears that may affect their swimming program

We from time to time will take photographs of the children swimming and may use these photographs in our swim school promotional material.

Do you object to photographs being taken
Do you give permission for us to use these images in promotional material
I acknowledge that all the above answers are true and correct and acknowledge I have read and understand the policies