Swimwell Application Form
Swimmer's Name:

Swimmer's Date of Birth:

Address Line 1:

Address Line 2:

Address Line 3:

Post Code:

Phone Number:

Phone Number 2:

Email:

Medical Problems:

Venue:

Day:

Time:

Gender:

Class size:

Class type:

Swimming standard:

Last award received:

Where did you hear about us:

Name of parent/guardian/adult pupil:

Notes:





We will contact you if your requested class is not available, or to confirm a booking. Comments can be written in the book provided at the pool. S wimwell and the pool authorities take no responsibility for the loss or damage of personal possessions. No food or drink to be taken to the pool side. We do not refund or carry over missed lessons unless cancelled by us. Swimwell are fully insured. Cancelled courses or lessons are non-transferable and non-refundable.
Manger on duty, contactable via text or email. No contact bookings.