Welcome to Burnham-on-Sea Swimming Club!

Please complete the details below which will then be sent to the Club Secretary. Note if the member is under 18 then contact details should be of the parent/carer and not the member.

This form is made up of three sections. Part 1: Membership Form, Part 2: Photography Declaration Form & Part 3: Medical Information & Declaration Form.

At the end of each page, click "Next" and it will take you to the next section.

If you have multiple swimmers joining the club, a new form will need to be completed for each swimmer. At the end of all sections after submitting you will see a link called "submit another response", click this link for each additional swimmer.

If you have any questions regarding the completion of this form, please email Kelly at or Lewis at

Below are links to important documents to be read by yourself and the swimmer. Completing this form shows your acceptance to these terms.

Code of conduct for parents -

Code of conduct for swimmers -

Code of conduct for coaches & teachers -

Burnham-on-Sea Swimming Club Constitution -

EU GDPR Privacy Statement -

Finally a link to the different categories of ASA membership available to you.

ASA Membership Categories -

Name of Swimmer *
Your answer
Known as (if applicable)
Your answer
Swimmers Date of birth *
Male/Female *
Ethnicity *
Telephone *
Your answer
Email *
Your answer
Address *
Your answer
Is this the only club the swimmer is a member of? *
If no, please name other club in "Other" box
ASA Membership Number (If known)
Your answer
1st Contact Name, Relationship, Telephone *
Your answer
Any additional information?
Your answer
2nd Contact Name, Relationship, Telephone *
Your answer
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