Full Name *

First Name

Last Name

Date of Birth

MM

DD

YYYY

Full Name

First Name

Last Name

Do you/your child suffer from any medical conditions? *

Yes

No

Do you/your child require any specific medication? *

Yes

No

Are you/your child allergic to anything? *

Yes

No

Have you/your child been immunised against Hepatitis B? *

Yes

No

Have you/your child been immunised against Tetanus? *

Yes

No

Is there any other information you would like us to be aware of? *

Yes

No

What is your child's swimming ability? *

Poor

Average

Excellent

Stroke Development - Dolphin

Learn to swim session focusing on breaststroke.

Monday - 6.45am to 7.15am

Monday - 4.30pm to 5pm

Tuesday - 4.30pm to 5pm

Wednesday - 6.45am to 7.15am

Thursday - 4.30pm to 5pm

Friday - 6.45am to 7.15am

Saturday - 6.30am to 7am

Stroke Development - Stingray

Learn to swim session focusing on butterfly.

Monday - 6.45am to 7.30am

Monday - 5pm to 5.45pm

Tuesday - 5pm to 5.45pm

Wednesday - 6.45am to 7.30am

Thursday - 5pm to 5.45pm

Friday - 6.45am to 7.30am

Saturday - 6.15am to 7am

Stroke Development - Mini Squad

Focusing on specific skills development, like dives, tumble turns, reading the clock and squad etiquette this is a great introduction to squad training.

Monday - 6.30m to 7.30am

Monday - 4.30pm to 5.30pm

Tuesday - 4.30pm to 5.30pm

Wednesday - 6.30am to 7.30am

Thursday - 4.30pm to 5.30pm

Friday - 6.30am to 7.30am

Saturday - 6.15am to 7am

Squads - Junior Squad

Focusing on making a smooth transition from Mini Squad to our main squad program, Junior Squad focuses on further refining specific stroke skills, squad etiquette, endurance, and strength and conditioning training.

Monday - 6.30am to 7.30am

Monday - 4.30pm to 5.45pm

Tuesday - 4.30pm to 5.45pm

Wednesday - 6.30am to 7.30am

Thursday - 4.30pm to 5.45pm

Friday - 6.30am to 7.30am

Saturday - 6am to 7am

Squads - Senior Squad

The Senior Squad caters for a wide range of primary and high school-aged swimmers, from those targeting school, district and regional competitions to those keen to swim for fitness.

Monday - 5.30am to 7am

Monday - 6.45am to 7.45am

Tuesday - 4.30pm to 6pm

Wednesday - 5.30am to 7am

Wednesday - 6.45am to 7.45am

Thursday - 4.30pm to 6pm

Friday - 5.30am to 7am

Friday 6.45am to 7.45am

Saturday - 6am to 7am

Heads Up - Water Polo Swim Fit

Customised swim training essential for building the foundation of a water polo player's skillset.

Monday - 6.45am to 7.45am

Wednesday - 6.45am to 7.45am

Squads - Adult Squad

Our Adult Squads are designed for those new to squad swimming through to those who swim for fun, fitness or competition, including triathlon. 

Monday - 5.30am to 7am

Tuesday - 6pm to 7pm

Wednesday - 5.30am to 7am

Thursday - 6pm to 7pm

Friday - 5.30am to 7am

Saturday - 6am to 7am

Adult Squad Payment Options

If you have selected Adult Squad, please select your preferred payment alternative:

Monthly pass

10 session pass

Breakfast

If you have selected any morning sessions, please indicate below if you would like breakfast included. ($40 per morning for 10 week term)

Monday

Wednesday

Friday

I, the parent/guardian of the 'swimmer' (as referenced above) consent to: *

1. The child participating in any event promoted by The Swim Academy, including any tour or camp. 2. The Swim Academy staff/parent supervisors obtaining medical attention for the child at their discretion or in the event of an illness or an accident, and agree to pay any medical, pharmaceutical and ambulance/helicopter etc. transport expenses. 3. The child to be driven in a car or bus hired, chartered or driven by The Swim Academy staff or parent supervisors. 4. The Swim Academy staff/parent supervisors to give the child paracetamol or ibuprofen if he/she requires it for minor pain relief.

I consent

I, either in my own right and/or as a person with lawful authority of the child referred to in this registration form, confirm that: *

I consent to The Swim Academy staff or supervisors taking photographs of me and/or the child for use in The Swim Academy marketing material. I am aware that The Swim Academy staff members are not medically trained, but do have first aid training, and give consent to The Swim Academy staff to seek medical treatment for me and/or the child from a medical practitioner, hospital or ambulance service. In consideration of, and as a condition of The Swim Academy permitting me and/or the child to use the Stuartholme School Swimming Pool and the equipment contained within it (“Facilities”) or to participate in any Tour, Camp or other activity prompted by The Swim Academy (“Activity”), I hereby acknowledge that: 1. There are significant risks associated with the use of the Facilities or participation in any Activity. 2. Those risks include, but are not limited to, personal injury arising from use and misuse of the equipment, equipment failure and the acts, omissions or negligence of other Facilities users or Activity participants. 3. At all times whilst I and/or the child are using the Facilities or participating any Activity I will assume sole responsibility for all risks associated with property and person. 4. I will not hold The Swim Academy or its owners liable for any personal injury or loss or damage to my and/or the child’s property whatsoever, including caused by the negligence of The Swim Academy owners, their employees or agents. I also undertake not to sue The Swim Academy owners or their employees or agents for any loss or damages relating to personal injury or loss or damage to property arising from the use of the Facilities or participation in any Activity.

I consent

How did you hear about us? *

Website

Stuartholme family

Friends

School newsletter

Other

If you have a daughter currently swimming in any program offered by The Swim Academy is she currently on an enrolment list at Stuartholme School?

Yes

No

If not, would you like the School to contact you about enrolment opportunities at Stuartholme?

Yes

No