2023 SE London Poolside Pass Application

1
By completing this form, you are permitting SE London to contact you on the email you provide should we need to communicate regarding any SE London meet in 2023. Your email will be deleted from this submission after all 2023 meets have been completed in accordance with our Data Protection Policy set out in the Promoter's Conditions of each meet.
2
Full Name* This field is required.Full name of Applicant
Forename(s)
Surname
3
Club/Organisation Name* This field is required.Please select from the list below.
Anaconda SC
Aquavision North London Swim Club
Avondale SC
Barking & Dagenham Aquatics Club
Barnes SC
Barnet Copthall SC
Barnet Water Polo Club
Beckenham SC
Bethnal Green SC
Bexley Masters SC
Bexley SC
BJSC Tooting
Bor of Waltham Forest (Gators)
Borough of Harrow S C
Brent Dolphins SC
Bromley SC
Brompton SC
Broomfield Park SC
BUCS
Cally Masters Islington
Camden Swiss Cottage SC
Cheam Marcuda SC
Chelsea & Westminster SC
Chislehurst Millennium Swim Squad
Chiswick Masters
Citizens Water Polo Club
Croydon Amphibians SC
Crystal Palace Diving Club
Dive London Aquatics Club
Dulwich Dolphins
Ealing SC
Eastern Otters Water Polo Club
Eaton Square SC
Eltham Stingrays
Enfield Swim Squad
Erith & District SC
Feltham SC
Forward Hillingdon Squad
Frognal Masters Swimming Club
Greenwich Royals SC
Hackney Aquatics Club
Hampstead Heath Winter SC
Haringey Aquatics
Harrow Scout & Guide SC
Havering Cormorants Diving Club
Havering Dolphins
Hillingdon Swimming Club
Hornchurch SC
Hounslow Jets
Imperial College Union Synchronised Swimming
Isleworth Penguin SC
Killerwhales SC (Havering)
Kings Cormorants SC
Kingston Royals SC
Leander SC
Lewisham Water Polo Club
Leyton SC
London Bor of Enfield WPC
London Borough of Hounslow
London Borough of Redbridge SC
London Disability SC
London Region
London Regional Synchronised SC
Merton Pisces
Merton Sch of Diving & T
Merton Swordfish SC
Metropolitan Police SC
Middlesex County ASA
Mitcham Marlins Swimming Club
Morden Park DC
Newham & University of East London (UEL) Swimming Club
North London Water Polo
Old Whitgiftians SC
Orpington Ojays
Otter SC
Out To Swim
Polytechnic S&WP Club
Richmond Swimming Club
Romford Town SC
Ruislip Northwood Masters SC
Saxon Crown (Lewisham) SC
Serpentine SC
Seymour Synchro Swim Sch
Sharks SC of Mottingham
South Croydon SC
South London Open Water SC
South West London Diving Club
Southwark Aquatics SC
SouthWest LondonFin SC
Spencer Swim Team
St James SC
St Pauls School Aquatic Club
Streatham SC
Survive And Save Club
Sutton & Cheam SC
Swim England
Teddington SC
Teddington Torpedoes
Tower Hamlets SC
Turtles Of South London SC
Waltham Forest Diving Club
Wandsworth SC
West London Penguin Swimming & Water Polo Club
Westminster Tiburones SC
Whitgift Swimming Club
Wimbledon Dolphins SC
Woodside & Thornton Heath SC
4
Swim England Club Code* This field is required.Please select from the list below.
ANCL
AQNL
AVOL
BACL
BANL
BATL
BEGL
BEKL
BEML
BEXL
BOBL
BRBL
BROL
BRYL
BUCL
BWCL
BWFL
CHLL
CHML
CMIL
CMSL
CROL
CRYL
CSCL
CWPL
CWSL
DLAL
DUDL
EALL
EASL
ECDL
EMSL
ENSL
EOTL
ERIL
EWPL
FELL
FMSL
FORL
GWRL
HABL
HAGL
HAPL
HAWL
HDOL
HHWL
HISL
HOJL
HORL
HRWL
ICSL
ISLL
KCSL
KEYL
KILL
KIRL
LBRL
LEAL
LHOL
LODL
LONL
LRSL
LWPL
MDXL
MERL
MMSL
MPDL
MPIL
MSDL
MTPL
NLWL
NUEL
OOJL
OTTL
OUTL
OWTL
POLL
ROML
RSCL
RUIL
SAQL
SAXL
SCRL
SERL
SHKL
SJAL
SLSL
SPAL
SPEL
SPSL
SSSL
SSVL
STML
SUTL
SWDL
SWLL
SWME
TEDL
TOWL
TTOL
TURL
WANL
WFDL
WHSL
WMBL
WOOL
WTIL
5
Applicant Category* This field is required.Teachers should complete the separate form on the London website for a poolside pass
Trainee Technical Official
VIP Guest
Field of Play Volunteer
SE London Staff
Personal Care Attendant
6
Has your Club achieved SwimMark (formerly Swim21) accreditation?* This field is required.If not, you will need to provide additional information for Child Welfare and Safeguarding reasons.
YESNO
7
Swim England registration number * This field is required.Formerly ASA number
8
Date when "Safeguarding & Protecting Children" course was attended* This field is required.It must be within the last three years.
Date
Day
Month
Year
9
DBS Number* This field is required.Please provide the Reference Number provided when your DBS Check was submitted.
Numeric characters only, no spaces.
10
Swim England registration number Formerly ASA number
11
Email Address of Applicant* This field is required.
example@example.com
Confirm Email
12
Emergency Phone Number* This field is required.Main mobile or landline contact number in case of an emergency.
First 5 digits
Last 6 digits
13
How do you want to upload your photo?* This field is required.
Use the camera on my laptop or mobile device
Use a photo I already have on my device
14
Take your Photo using your WebCam or Mobile Device* This field is required.If you do not have this facility available, click previous and select "Use a photo I already have on my device".
15
Upload Image for Pass* This field is required.Please upload an electronic image file which accurately represents your current appearance.
Drag and drop files here
Select files to upload
Max. file size: 4.0MB
JPG, JPEG & PNG files only - max 4MB in size
Cancelof
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UNIQUE PASS REFERENCE #
Should be Empty: