Swim School Assessment Questionnaire

1

Please provide us with your contact details* This field is required.Our Customer Care Team will only use your contact details to contact you about enrollment into swimming lessons.

First name

Last name

Email

Phone

Child's age

2

Has your child had formal swimming lessons before?* This field is required.If you're unsure of the answer please select no.

YESNO

3

Please watch the video and then click next to answer the question

4

Is your child confident in the water and can they submerge?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

5

Please watch the video and then click next to answer the question

6

Can your child streamline float (face in) for at least 3m?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

7

Please watch the video and then click next to answer the question

8

Can your child streamline kick with the correct body and head position?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

9

Please watch the video and then click next to answer the question

10

Can your child float on their back with minimal/no assistance?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

11

Please watch the video and then click next to answer the question

12

Can your child coordinate paddling and kicking?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

13

Please watch the video and then click next to answer the question

14

Can your child swim 5m with co-ordinated arm circles and kicking?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

15

Please watch the video and then click next to answer the question

16

Can your child kick 5-10m on their back with their arms by their side?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

17

Please watch the video and then click next to answer the question

18

Can your child kick strongly on their back with their arms by their side and/or in a streamline position?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

19

Please watch the video and then click next to answer the question

20

Has your child been introduced to rolling to breathe?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

21

Please watch the video and then click next to answer the question

22

Can your child swim 10m rolling to breathe every third stroke?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

23

Please watch the video and then click next to answer the question

24

Can your child swim freestyle with the correct technique? If yes, for what distance?* This field is required.This question relates to the previous video. If you're unsure of the answer please select 10m-12m.

Between 10m - 12m

Between 12m - 20m

Between 20m - 25m

Between 25m - 50m

Between 50m - 100m

25

Please watch the video and then click next to answer the question

26

Can your child swim backstroke with the correct technique? If yes, for what distance?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

Between 0 - 12m

Between 12m - 20m

Between 20m - 25m

Between 25m - 50m

Between 50m - 100m

27

Please watch the video and then click next to answer the question

28

Can your child swim breaststroke with the correct technique? If yes, for what distance/ability?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

No

They have an awareness of breaststroke kick

2 cycles with glide

Between 25m - 50m

Between 50m - 75m

29

Please watch the video and then click next to answer the question

30

Can your child swim butterfly with the correct technique? If yes, for what distance/ability?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

No

They have an awareness of butterfly kick

10m butterfly kick

Butterfly kick with arms in a streamline

5 cycles

15m

31

Please watch the video and then click next to answer the question

32

Can your child do touch turns, tumble turns and pull-outs?* This field is required.This question relates to the previous video. If you're unsure of the answer please select no.

YESNO

33

Can your child swim 100m freestyle in under 2 minutes and 15 seconds?* This field is required.

YESNO

34

Can your child swim 200m freestyle in under 4 minutes ?* This field is required.

YESNO

35

Can your child swim 400m freestyle in under 7 minutes ?* This field is required.

YESNO

36

Teen Beginner - Thank you for taking the time to fill out this form. Your child is best suited to our Teen Beginner level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.

37

Teen Learner - Thank you for taking the time to fill out this form. Your child is best suited to our Teen Learner level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.

38

Intermediate Swim 25 - Thank you for taking the time to fill out this form. Your child is best suited to our Intermediate Swim 25 level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.

39

Intermediate Swim 50 - Thank you for taking the time to fill out this form. Your child is best suited to our Intermediate Swim 50 level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.

40

Transition - Thank you for taking the time to fill out this form. Your child is best suited to our Transition level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.

41

Development 1 - Thank you for taking the time to fill out this form. Your child is best suited to our Development 1 level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.

42

Development 2 - Thank you for taking the time to fill out this form. Your child is best suited to our Development 2 level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.

43

Fitness - Thank you for taking the time to fill out this form. Your child is best suited to our Fitness level.* This field is required.Please click the image to proceed to the next screen. Please note this questionnaire gives us an approximation of the level best suited for your child. Your child will be informally assessed during their first lesson to ensure they are in the correct level.