enrolment

To enrol fill in or download the form below

Enrolment

Please fill out the enrolment form below
which needs to be completed (if a new starter) and returned with payment to:

JH Swim School
HSBC
Acc. No: 31430017
Sort Code: 40-30-25
Cash is also accepted

Alternatively you can download a manual form here

Download Manual Form

Enrolment Form

Name*

Date of birth

Phone

Your email*

Address:

Present Ability:

Non Swimmer (not yet swimming independently)BeginnerImprover

If already swimming please state the highest certificate/award already received:

Distance

Water Skills

Survival

Stage

Is your child suffering from any medical condition?

YesNo

Is your child under medical supervision?

YesNo

Is your child currently taking prescribed drugs or have done so within the last six months?

YesNo

Does your child have a visual or hearing impairment?

YesNo

If Yes to any of the above, please describe briefly:

Other medical history, including special needs or learning difficulties/disabilities, information processing, social/emotional need, ASD, ADHD etc:

SHOULD ANY MEDICAL/BEHAVIOURAL ISSUES DEVELOP AT ANY TIME THROUGHOUT THE COURSE DURATION PLEASE NOTIFY JANE IMMEDIATELY

Name of Parent/Guardian/Carer

By ticking this box you agree you have read, understood and will adhere to the Guidelines/Rules & Regulations on the Information Page and have read and agree with the Privacy Policy

Jane Hayman, Gingerbread Cottage, Glovers Lane, Hastingwood, Essex CM17 9LA | 07956 833586 | info@jhswimschool.co.uk