Membership request
Complete the form below to register your interest:
Swimmers name *
Please provide the swimmers first and last name, you don't need to provide any middle names or initials.
Your answer
Date of Birth *
Please provide the swimmers date of birth
Swimmers experience *
This is really very important, please indicate your swimmers highest level of experience, have they taken swimming lessons only, or competed within a club environment before? What is their experience of diving, turning, etc.
Your answer
Health Concerns
Does your swimmer have any health concerns that should be brought to the coaches attention?
Your answer
Primary Contact name
Please provide parent/carers name
Your answer
Phone number (main contact number)
Please provide yours, or your parent/carers telephone number
Your answer
Contact email: *
Your answer
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