Swim England & Haringey Aquatics Memberships Registration and Renewal for 2018
A copy of your responses to this form will be emailed to you. Please provide main contact's email address.
Email address *
Membership Renewal 2018
All members of Haringey Aquatics should use this document for the renewal of Swim England (former ASA) Registration and any changes of personal details.

Membership is renewed ONLY on completion of these forms AND receipt of Membership Fees.
MEMBERS ARE NOT INSURED OR ALLOWED TO TAKE PART IN ANY AQUATIC ACTIVITIES IF YOUR ANNUAL MEMBERSHIP IS NOT PAID.

I wish to *
Required
Members Surname *
Your answer
Members Forename *
Your answer
Date of Birth *
dd/mm/yyyy
Your answer
Gender *
Full Address *
Your answer
Postcode *
Your answer
Primary Contact - Please write Name, Relationship to Member, Telephone Number and Email Address *
Please provide at least one
Your answer
Secondary or Emergency Contact - Please write Name, Relationship to Member and Telephone Number
Must be a responsible adult. Add email address ONLY if you wish for communications to be ALSO sent to this address
Your answer
Medical Information *
Does the member have any health concerns, disabilities or special needs that the instructors/coaches should be aware of? Please also write if the member requires any medication.
Your answer
Haringey Aquatics Codes of Conduct *
Photography Consent *
Haringey Aquatics may wish to take photographs of individuals or groups of swimmers/divers/waterpolo players under the age of 18. All photos will be taken and published in line with ASA policy. Photographs may be taken to use on the club’s secure website, to include with newspaper articles, to use on club notice boards, for advertising and marketing purposes or for video for training purposes. A professional photographer (suitably approved) may take photos at competitions attended.
Swim England Registration Number *
Enter your family name on this website to find your membership number http://www.swimming.org/swimengland/club-member-check/ If you are not yet registered, please type 'not registered'
Your answer
Which category of membership are you applying for OR are you renewing *
Activity with Haringey Aquatics *
Please tick any of the relevant boxes below
Required
Country of International Representation *
Please specify
Disability Details
Please tick nature(s) of disability
Ethnic Origin
This question is OPTIONAL, however Haringey Aquatics is moving towards being more representative of our communities. To this end, the Committee monitors the composition of the Club to review progress. The collected data will be used only for statistical analysis reported to the Committee.
Your answer
Account to pay *
Money is NOT taken out of your account on submission of this form. Membership is not renewed until full payment is received.
Please use the member's "Name Surname/SE18" as reference for your payment when applying for or renewing the annual Swim England membership
Existing members must renew by 31st January 2018, failure to pay by this date will result in the membership being lapsed.
To reinstate a lapsed membership after 31st January 2018 a £10 administration fee per member will apply on top of normal fees.
Declaration
I understand that a Registration fee to Swim England is payable on joining and then every January thereafter.

I understand that the club itself charges an annual fee which for convenience is split into twelve equal monthly installments, which is payable on the 1st of the month as set by the Committee.
On joining, the first month must be paid via online banking. Fees are variable depending by discipline and level of training.

I will reference all payments as instructed.

I understand that when a member leaves the club, the club requires one month notice in writing (email ha.members@gmail.com for swimming&waterpolo and hadiving@gmail.com for diving)

I understand that Haringey Aquatics is a competitive club and that its members may be selected to represent the club at various competitions. When invited, members must confirm as soon as possible whether or not they will attend to the allocated Team Manager.

I will inform the club at once if our details (address, phone number, email address) change.

Signature *
Parent/Carer or Member over 18 years old
Your answer
A copy of your responses will be emailed to the address you provided.
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