Charlestown Swimming Pool - Booking Form
Please submit a form for each child you are registering.
Programs are non-refundable. Registration does not guarantee program space. Only payment in full guarantees your child's place. Registration and payment must be completed by the Saturday before the program begins. Thank you!

PROGRAM UPDATES
Swim Lessons Session 2 10:30 - 11:15 : Level 1 - FULL; Level 2 - 3 spaces left; Level 3 - FULL; Levels 4 & 5 - FULL
Swim Lessons Session 2 11:30 - 12:15 : Level 1 - FULL; Level 2 - FULL
and 12:30 - 1:15 Updates to follow

*** Season Ticket holders receive 10% discount off the below programs
Email address *
Name of Parent/Guardian
Your answer
Contact Num/Emergency Contact Num
Your answer
Address
Your answer
Choose your program *
Swim Lessons Session 2 10:30 - 11:15 : Level 1 Now Full; Level 2 - 2 spaces left; Level 3 - 1 space left; Levels 4 & 5 - 1 space left *** Season Ticket holders receive 10% discount off the below programs
Member
Name of Swimmer
Your answer
Swimmer Date of Birth
MM
/
DD
/
YYYY
Swim Level (for Camp & Swim Lesson Sessions)
Select swim level for Swim Camp and for Intensive Swim Lessons
IWS Water Safety Level for 2019 (for WSW only)
Select the Irish Water Safety Level that you are signing up for the Summer 2019 session
Does your child have any medical conditions
Medical Condition Info
Your answer
My child and I have read and will abide by the Pool Rules
Our Privacy Policy details how Personal Data is managed. For IWSA Water Safety Classes, information will be shared with Irish Water Safety to record awards and process certificates. Charlestown Swimming Pool may email or text me about the pool services.
Cheques: Please make payable to Charlestown Swimming Pool Recreational Company Ltd
Payment Type
Cash and cheque payments may be made at the pool. For EFT, details are below.
EFT: Please include your name in the reference so we know the payment is from you 😁
Account Name: Charlestown Swimming Pool Recreational Co. Limited; Bank/Branch: AIB Swinford; BIC: AIBKIE2D . IBAN: IE68 AIBK 9372 6605 7081 87
A copy of your responses will be emailed to the address you provided.
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