Swimunity Summer Term Learn to Swim Course
Saturday 11th June 2022 - Saturday 16th July 2022
Swimmer One
*
First Name
Last Name
Date of Birth
*
/
Day
/
Month
Year
If you have swam with us previously, which colour hat was your child awarded?
Red
Orange
Yellow
Green
Blue
Purple
Full Swimunity Colours
None
If you have not swam with us before, tell us about your child's water confidence - Any previous swimming experience?
None (total beginner, may have been to the pool a few times to splash around)
Limited (happy to wet face, blow bubbles, move around in shallow water and float with help)
Essential (able to hold breath, happy to submerge, move around in shallow water, streamline and float unaided)
Various (happy to be in and moving around the water unaided, floating/submerging, push and glide, can take feet off the floor confidently, some knowledge of freestyle/backstroke fundamentals, may have had lessons before)
Plenty (my child is basically a Fish/Mermaid/Aquaman and needs to fine tune their skills)
Click here if you would like to sign up a second swimmer in your family
Swimmer Two
First Name
Last Name
Date of Birth
/
Day
/
Month
Year
If you have swam with us previously, which colour hat was your child awarded?
Red
Orange
Yellow
Green
Blue
Purple
Full Swimunity Colours
None
If you have not swam with us before, tell us about your child's water confidence - Any previous swimming experience?
None (total beginner, may have been to the pool a few times to splash around)
Limited (happy to wet face, blow bubbles, move around in shallow water and float with help)
Essential (able to hold breath, happy to submerge, move around in shallow water, streamline and float unaided)
Various (happy to be in and moving around the water unaided, floating/submerging, can push and glide and take feet off the floor confidently, some knowledge of freestyle/backstroke fundamentals, may have had lessons before)
Plenty (my child is basically a Fish/Mermaid/Aquaman and needs to fine-tune their skills)
Back
Next
Have you registered your details with us before?
Yes (Please only answer the starred [*] questions, scroll to the bottom, and Submit)
No (Please fill in all the details below)
Name of Parent/Guardian
*
First Name
Last Name
Email
*
parent@example.com
Address
Flat/House Number and Name
Street/Road Name
Borough
City
Post Code
Phone Number
Please enter a valid phone number, in case we need to contact you.
Ethnic Heritage
This is for statistical purposes on how diverse our outreach is, all the information collected is confidential.
Please list any medical/special educational needs
allergies, intolerances, autism, etc
How did you find out about Swimunity?
Please Select
Word of Mouth - family & friends
Posters in the local area
Instagram
Newspaper Article
Other (please specify in the box below)
Please select one, or if 'other' let us know in the box below.
If you selected 'other' in the previous question, please specify.
Photo Consent - We may take photos/videos to showcase the progress of the program to past and future funders, for evaluation purposes, and also on our social media page. Do you give consent for photos/videos to be taken of the above named swimmer/s?
*
Yes
Not this time
Please double check the details you have entered are correct, and finally, hit submit!
Thank you for your interest, and good luck!
Submit
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