Nuna Aqua Power New Customer Enquiry Form
Parent Details
Name
*
First Name
Last Name
Athlete Details:
Full Name of athlete
*
First Name
Last Name
Date of Birth
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
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How many sessions per week are you looking to train?
*
What is your CURRENT training schedule?
*
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Do you currently or have you ever had a National qualifying times?
*
Yes
No
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Please list below National times that you currently hold or have previously held and in what Age group.
*
Please click yes to continue
*
Yes
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Do you currently or have you ever had a State qualifying times?
*
Yes
No
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Please list below all State times that you currently hold or have previously held and in what Age group.
*
Please click yes to continue?
*
Yes
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Do you currently or have you ever had any Junior Excellence Times
*
Yes
No
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Please list below all JX times that you currently hold or have previously held and in what Age group.
*
Please click yes to continue?
*
Yes
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Can you swim 100M Freestyle, backstroke, breaststroke and 50m Butterfly?
*
Yes
No
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Based on your answers you may qualify for our National squad. Our Head Coach Michal Skrodzki will be in touch to discuss a trial
Do you consent for Michal to contact you regarding your squad placement
*
Yes
No
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Based on your answers you may qualify for our State squad. Our Head Coach Michal Skrodzki will be in touch to discuss a trial
Do you consent for Michal to contact you regarding your squad placement
*
Yes
No
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Based on your answers you may qualify for our Club stream squads (Intermediate & Junior). Our Head Coach Michal Skrodzki will be in touch to discuss a trial
Do you consent for Michal to contact you regarding your squad placement
*
Yes
No
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Based on your answers you do not currently qualify to join the Nunawading Aqua Power swimming Club squads. However Ivanhow Girls Grammer provides Mini squads and higher levels of learn to swim through at the IGGS pool
Do you agree to IGGS contacting you to discuss your child's swimming needs
*
Yes
No
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Thank you for contacting Nunawading Aqua Power
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