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About us
Clubs
Courses
Artistic Swimming
Disability
Diving
Open Water
Masters
Swimming
Water Polo

Swimming Camp Registration

Dates: 20th – 22nd February 2020

Venue: Loughborough

Cost: £130 per swimmer

Registration and payment deadline: 31st January 2020 – Payment details will be emailed to you on completion of the registration form.

Please read our data protection, photography and code of conduct policy before signing up using the below form as all athletes will be expected to adhere to the code of conduct throughout the trip.

Form Submission is restricted

Form is successfully submitted. Thank you!

Swimming Camp – Loughborough, February 2020

Athlete Registration Form

Forename:*

Surname*

Club:*

Swim England Membership Number:*

Parent/Guardian Email Address:*

Please select the athlete’s t-shirt size:

Child Age 14-15

Adult Small

Adult Medium

Adult Large

Please select the athlete’s hoody size:

Child Age 12-13

Adult Small

Adult Medium

Adult Large

Does the athlete have any allergies?*

Yes

No

Does the athlete have a current medical condition?*

Yes

No

Does the athlete currently take any medication?*

Yes

No

Does the athlete have a disability?*

Yes

No

If you have answered yes to any of the above questions, please provide further details:

Emergency Contact 1 – Name:*

Emergency Contact 1 – Telephone Number:*

Emergency Contact 1 – Second Telephone Number:*

Emergency Contact 2 – Name:*

Emergency Conact 2 – Telephone Number:*

Emergency Contact 2 – Second Telephone Number:*

I confirm I have read and agree to the Swim England East Region policies document (data protection, photography and code of conduct)*

Yes

No

I confirm I am able to pay the camp fee in full by the stated deadline:

Yes

No

I confirm that I am happy for Swim England East Region to store information submitted via this form and contact me in relation to the East Region Swimming Camp.*

Yes

No

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