X Lab Trial Registration Form (Upated)

1
Which program are you interested in?* This field is required.
Competitive Squad
Masters
Development Squad (only at Hwa Chong Pool)
Private Comp Coaching
2
How did you hear about us?* This field is required.
Facebook
Instagram
Google Search
Family/Friends Referral
Brochure
Not So little Fair
Swim Clinics
Word of mouth/ Google Reviews
Other
3
Only applicable to Masters Squad:
4
Please share the details for the person that referred you* This field is required.Parent Name or Guardian's Name
First Name
Last Name
5
Location* This field is required.
X Lab @ XCL (Yishun)
X Lab @ Hwa Chong (Bukit Timah, only for Dev Squad)
I have access to a private training pool (for competitive private coaching only)
6
Parent/Guardian's Name* This field is required.Note: This section is only applicable to swimmers below the age of 18. If you're signing up for the Masters squad, please indicate N/A.
First Name
Last Name
7
Parent/Guardian's NRIC/FIN/Passport Last 3 digits + letter (Ex. 123X)
Last 3 digits + letter (Ex. 123X)
8
Email* This field is required.Important updates will be sent to this email
Important updates will be sent to this email
9
Phone Number* This field is required.Please note that all our communications and updates will be conducted via WhatsApp. If you do not have WhatsApp, kindly email us after completing the form so we can assist you accordingly."
10
Swimmer's Postal Code
11
Swimmer's Name* This field is required.
First Name
Last Name
12
Swimmer's preferred name * This field is required.How would you like us to address your child
How would you like us to address your child
13
Swimmer's NRIC/Passport/FINLast 3 digits + letter (Ex. 123X)
Last 3 digits + letter (Ex. 123X)
14
Swimmer's Gender* This field is required.
Male
Female
15
Swimmer's Date of Birth * This field is required.
Month
Day
Year
16
Emergency Contact Name
First Name
Last Name
17
Emergency Contact Number
Please enter a valid phone number.
18
Does he/she have any swimming experience? If any, please specify what strokes he/she is able to do.* This field is required.
19
Do you have any prior swimming experience or squad training background? If yes, please share details such as your previous swim club, level of training, competitions participated in, and key strokes or timings (if known).* This field is required.Please insert N/A if not applicable
20
Preferred Tryout Days* This field is required.For Masters Squad: Please select onlyTuesday and/or Thursday sessions.
Please Select
Please Select
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
21
What are your goals in joining the X Lab Competitive Squad?Optional
Huge
Large
Normal
Small
Ok
Ok
22
What your goals in joining the squad?
Improve swimming technique
Build speed & endurance
Compete in swim meets
Enhance overall fitness and discipline
For health / rehabilitation purposes
Long-term athlete development (pathway to elite squad)
Fun, enjoyment and social interaction
23
Insert Timings (if relevant)
Add timings (Please enter in MM:SS format)
50m freestyle
Row 0, Column 0
50m breaststroke
Row 1, Column 0
50m backstroke
Row 2, Column 0
50m butterfly
Row 3, Column 0
100m freestyle
Row 4, Column 0
100m IM
Row 5, Column 0
Row 6, Column 0
50m freestyle
50m breaststroke
50m backstroke
50m butterfly
100m freestyle
100m IM
Add timings (Please enter in MM:SS format)
Row 0, Column 0
Add timings (Please enter in MM:SS format)
Row 1, Column 0
Add timings (Please enter in MM:SS format)
Row 2, Column 0
Add timings (Please enter in MM:SS format)
Row 3, Column 0
Add timings (Please enter in MM:SS format)
Row 4, Column 0
Add timings (Please enter in MM:SS format)
Row 5, Column 0
Add timings (Please enter in MM:SS format)
Row 6, Column 0
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24
Private Session

Please email us at swim@xlab.com.sg, or you can give us a call at, 9664 1955 to book a private session.

You may also click her to message us via WhatsApp
25
Terms and Conditions (Please Read)* This field is required.
26
INDEMNITY FOR MINORS
The section below must be completed by the parent/guardian of the swimmer below the age of 21

I, {parentguardiansName}, Expressly warrant and represent that I am the parent or legal guardian of {swimmersName} on whose behalf I am completing this registration. I confirm that I have read the terms and conditions set out by X Lab Pro Pte Ltd and abide by the by-laws, including the Waiver and Release of Liability. As such, I hereby indemnify X Lab Pro PTE Ltd and its related companies from any injury and/ or loss of life during the course of the program.

Signature *
{parentguardiansName}
27
INDEMNITY FOR ADULTS
The section below to be completed by swimmers above the age of 21.

I, {swimmersName} , Expressly warrant and represent that I am physically fit and do not have any impairment that may make my participation unsafe for myself or others. I confirm that I have read the terms and conditions set out by X Lab Pro PTE Ltd and abide by the by-laws, including the Waiver and Release of Liability. As such, I hereby indemnify X Lab Pro Pte Ltd and its related companies from any injury and/ or loss of life during the course of the program.
Signature *
{swimmersName}
28
Electronic Signature Consent* This field is required.
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
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