Name: Date Of Birth: DD/MM/YY

Home Club Name: Age: As at 01 July

Coach: Preferred Stroke:

If you require your son to participate in a MINIMUM number of swim practices each day/week you must notify us in the space provided below. If we do not receive written instructions, we will allow your son to choose for himself how many sessions he attends.

Please detail below any specific swimming issues or information you wish to share with the coach.

Parent`s Signature Required For Camper To Participate in non-camp events:

The cost of attending any non-camp Swimming competition is the financial responsibility of the camper, all expenses incurred during the trip will be deducted from the campers store account. Campers will only be permitted to go if they have sufficient funds in their store account to cover the cost of the trip.