Covid-19 Health Questionnaire
Please only complete this form once you have been offered a space by a member of the KickStart Swim Academy Team and you have read the customer guide about Covid_19 and coming to lessons which can be found here: http://kickstartswimacademy.com/customer-guide-covid-19/

It is important that any person who enters any part of the pool is medically and physically fit and is not a danger to themselves or the health and safety of others. If you are not sure, you should seek medical guidance from NHS 111

This form should be completed as soon as possible and any change in circumstances communicated to via email to info@kickstartswimacademy.com
Swimmer first name *
Swimmer second name *
2nd Swimmer first name
Only required if there is a second swimmer within the same household
3 rd Swimmer first name
Only required if there is a second swimmer within the same household
2nd Swimmer second name
Only required if there is a second swimmer within the same household
3rd Swimmer second name
Only required if there is a second swimmer within the same household
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