AAARegistration Form

Aqua Attack Swimming Club / Swimming WA

Enrolment Form
Swimmer
Name*

First NameMiddle NameLast Name
Gender*
Date of Birth*

DayMonthYear
Date
Australian Citizen*
Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Parent / Guardian
Name*

First NameLast Name
Phone Number
Mobile or Home
Work
Email
example@example.com
Emergency Contact
Name*

First NameLast Name
Relationship to Child*
Phone Number*

Area CodePhone Number
Please provide details of any allergies or conditions of which the club should be aware.
Swimming WA

I agree to abide by the rules, regulations and policies of Swimming WA, Swimming Australia, the relevant Regional Swimming Association and Aqua Attack Swimming Club, including Swimming Australia's Anti-Doping,

Member protection and Privacy Policies (available at www.swimming.org.au)

I authorise Aqua Attack / Swimming WA to use and responsibly disclose, to related and relevant bodies any of my personal information that may be necessary to implement the rules, regulations and policies in 1 above. I agree to have my name, results and images (photo, sound grab, video or other representation) recorded during events conducted by Aqua Attack / Swimming WA, unless I or any guardian indicate otherwise, published in official programs, newsletters, websites and other media in an appropriate manner.

Aqua Attack Swimming Club

All fees and paperwork will be paid and submitted on time.

Non-Financial members will not be eligible to participate in club or Swimming WA run activities.

A member of the family will volunteer assistance when required at any competitions where their child is competing.

As representatives of Aqua Attack Swimming Club, members will behave with respect for the coaches, other swimmers, club volunteers and helpers, pool staff and general users of the pool.

Images and Social Media

At certain times throughout the year, our children may have the opportunity to be photographed or filmed for our club's newsletters, social media, newspaper(s) or website.

Aqua Attack may also wish to use swimmers' photographs/videos in print and online promotional marketing and media materials.

We would like your permission to use the swimmers' photographs/video.
My preferences for the use of the swimmers' imagery / videography are as follows.*

WebsiteSocial mediaClub promotion - electronic or printNewspapersDo not use the swimmers imagery / videography
I understand and agree that if my preferences change (with respect to the use of the swimmers imagery / videography), folllowing the submission of this form, it is my responsibility to notify the club.
Signature Member

Clear
Parent/Guardian Signature

Clear
Date

DayMonthYear
Date
Should be Empty:

Aqua Attack Swimming Club / Swimming WA

Enrolment Form

Swimmer