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Welcome
CHILLI SWIM MEMBERSHIP FORM 2023
  • 1

    WELCOME to the 2023 WINTER SWIM SEASON at ACTIVITIES AWAY.

     

    CHILLI SWIM CLUB sessions will start on SUNDAY 15th October 2023 and run EVERY SUNDAY from 9.30 am until 11.30 am up to and including SUNDAY 28th APRIL 2024

    This includes a BOXING DAY DIP and a NEW YEAR DAYS DIP!

    Please complete the form fully so we can be sure to have your details if we need them at any time during your participation.

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  • 2

    PLEASE READ OUR DATA PROTECTION INFORMATION

    We only collect the data we require so you can safely take part in the activity.

    We collect this data through this form which is processed by JOTFORM Inc. who store all the data collected off site at GDPR compliant servers based in Europe.

    We will only use your data for the purposes for which it has been collected, mainly -

    To identify you and/or your named emergency contact if required.

    To ensure we have a record of your contact details should we need to inform you of short notice closure or information in relation to your participation for any reason.

    To ensure we have any relevant medical details available for the emergency services if required.

    By completing this form you are agreeing we can hold this data in the way described and are agreeing that JOTFORM Inc. can process this data on our behalf.

    ALL data collected will be DELETED and PERMANENTLY REMOVED from the servers within 30 days if you request this in writting and no longer wish to use our facilities.

    If you have any questions about this process, the reasons we collect and hold data about you or how we hold, take care of and dispose of this data, then please email us BEFORE completing this form via email office@activitiesaway.uk

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    For us to communicate news about any short notice closures
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    Please enter your NEXT OF KIN address
    Please Select
    • Please Select
    • United States
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    On the next page you will be asked to enter any RELEVANT MEDICAL DETAILS that we may need to be aware of while you are participating.

    IF YOU HAVE NO MEDICAL ISSUES then please enter NONE on the next page.

    Things to include might be -

    I have an EPI PEN

    I suffer from Diabetes

    I suffer from Asthma

    I am Epileptic

    I take medication (which you then list)

    The key here is to mention anything you would want a paramedic to know if they were treating you at the scene or you would want them to tell a Dr at the hospital.

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    Please enter any RELEVANT MEDICAL DETAILS below on NONE if not relevant
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