VKSC Swim Academy Application Form
Thank you for your interest in the Vernon Kokanee Swim Club Swim Academy. Please fill out the application form to the best of your ability. Please submit your application by March 1st.

If you have questions regarding the program, please contact Corinne McWhinney via email at cmcwhinney@gmail.com or coach Jason Brockman at brockman8vksc@gmail.com.

For Vernon Kokanee Swim Club information visit our website at www.teamunify.com/Home.jsp?_tabid_=0&team=canvksc

Under the parents tab you will find information regarding club fees and training schedules. Please note that Swim Academy cost is in addition to regular program costs.

Academy Information can be found at: http://www.sd22.bc.ca/Programs/academies/Documents/Swim.pdf

Please note that students are responsible for their own transportation to and from the pool.

One of our swim academy committee members will contact you about the status of your application once it has been reviewed. Upon approval you will be required to provide a $50 non-refundable deposit to secure your registration. This will be applied towards your fees for the upcoming season.

Email address *
Student Name *
Your answer
Age *
Date of Birth *
MM
/
DD
/
YYYY
Grade (entering)
Address *
Your answer
Parent/Guardian Name(s) *
Your answer
Home Phone (or best number to reach you) *
Your answer
Cell Phone
Your answer
# Years experience Competitive Swimming *
Current Best Swim Time (short course) 200 IM *
Your answer
Current Best Swim Time (short course) 100 Free *
Your answer
Current Best Swim Time (short course) 400 Free
Your answer
Additional information you would like us to be aware of...
Your answer
A copy of your responses will be emailed to the address you provided.
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