Child/ Adult Member Boxing Day Swim 2019
Complete A Form For Each Participant
This form is for the use of those who are current NSVL members. If you’re not a current NSVL member, please use the day membership form which can be downloaded from or found at .
Upon completion of this form full payment must be made online using the following details: Account No: 00017963 Sort Code: 40-52-40 Ref: BDS and your surname.
Please provide contact details below, they will only be used to update you on swim arrangements. When filling in the medical conditions please give as much detail as possible.
Full Name: *
Your answer
Date of Birth: *
Email Address:
Your answer
Home phone/ Mobile phone: *
Your answer
Medical Conditions/ Disabilities:
Your answer
Next of Kin Name: *
Your answer
Next of Kin Home phone/ Mobile phone: *
Your answer
Please Note:
You will still need to ‘sign in’ on the day but this will be a lot quicker than for those who are not pre-registered and you are guaranteed a place.
Anyone under 16 taking part needs their parent/guardian to sign them in on the day.
See the club web site at for full details on the swim.
Do you want to pre-order a Commemorative T-Shirt? *
T-shirts can only be pre-ordered before Thursday 12th December. The cost to pre-order a T-Shirt is £6. There will be a limited number of T-Shirts to buy on Boxing Day at £10, but sizes cannot be guaranteed. All pre-ordered T-Shirts will be available for collection on Boxing Day.
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