Sponsored Mermaid Swim - World Record Attempt
Please fill this in for the swimmer taking part on September 22nd 2019. Please complete one form per swimmer.
Email address *
Mermaid swim
Full Name of Swimmer *
Your answer
Training session they are attending *
Required
Time Slot for the swimmer (e-mail me if you are not sure)
Your answer
Is the swimmer over 18? *
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
Parent/guardian name (if swimmer is under 18)
Your answer
Clothing Size (to help with allocating a tail)
Your answer
Emergency contact name and number *
Your answer
Medical information - Please tick any that apply
If you ticked yes to any of the medical information above, please add details here:
Your answer
Any other medical information we need to know?
Your answer
Do you have a disability you wish us to be aware of? Please state how best we can work with you or what adaptations you would like us to make (where possible).
Your answer
Choose ONE statement below about emergency medical care (only applies to swimmers under 18)
By completing this form, you are agreeing that you OR your child may take part in this event. There will be photography taking place - which, due to the nature of the event, will be used for local, national and international media purposes as well as for promotional purposes. There will be a separate photo consent form which will need to be completed. *
Required
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This form was created inside of Anna Haskell.