Name *

Email *

Phone *

Mailing Address *

Birth Date *

Current Swim Club *

Allergies and/or Medical Conditions *

I confirm my child can CONFIDENTLY swim freestyle for 50 m (2 lengths) *

I confirm my child can CONFIDENTLY swim backstroke for 50 M (2 lengths) *

I confirm my child can EXECUTE the basic kicking motion (Whipkick) and basic stroke requirements for breastroke for 25 M (1 length) *

I confirm my child can EXECUTE the basic kicking motion (Dolphin kick) combined with arm timing in butterfly for 15-25 M (approximately 1 length) *

By checking each of these boxes I agree and acknowledge that my child is capable of executing the above four requests. If, in the initial assessment of the child during the first training session, the child is not capable of completing each of these skills, I understand that my child will be asked to withdrawal from the camp and I will receive 50% of my camp fees in return. By checking the box below, I confirm that I understand what is being asked of me in registering my child for the camp and am confident in my child’s abilities (i.e., I have witnessed their abilities during a swimming or training session). *

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