Swimming Victoria Classification Registration Form 5th & 6th December 2026
Venue Melbourne Sports & Aquatic Centre, 30 Aughtie Drive, Albert Park
Swimmer Details
Name
First Name
Last Name
Date of Birth
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender:
Email:
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact / Parent or Guardian
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Availability
Saturday 5th December 2026
AM (start time before 12:00pm)
PM (start time after 1:00pm)
Sunday 6th December 2026
AM (start time before 12:00pm)
PM (start time after 1:00pm)
Why did you take up Swimming?
Swimming Victoria Affiliated Swimming Club ( If Applicable)
Do you need a classification for Regional School Sports?
If you are NOT affiliated with a Swimming Club, please provide details of your Learn to Swim program and number of lessons per week (if applicable)
Do you hold a Provisional Classification?
If you answered YES to the above question please state
Have you had any surgery within the past 12 months?
Please provide a brief description of Disability
Please upload Medical Diagnostics Form
*
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Please upload all medical documentation relevant to the swimmers disability
*
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