National Centre Ulster - Breaststroke / Butterfly Skills Clinic

National Centre Ulster - Breaststroke & Butterfly Skills Clinic

This Skills Clinic will be conducted by National Centre Ulster Coaches and Athletes assisting the swimmers to refine their skills.

The cost is £50 per athlete per clinic for 2 hours of intensive learning.

Swimmer should bring their net bag with fins, kickboard, snorkel, buoy, paddles etc.

Thursday 27.8.26 - 4.30pm-6.30pm – Breaststroke & Butterfly Skills Clinic

Name of Swimmer

First NameLast Name

Swimmer's Date of Birth

Date

Club

Email

example@example.com

Parent's Emergency Contact Phone Number - this is the number the Coach will call or text in an emergency or if the session is cancelled.

Area CodePhone Number

Medical Information & Consent Form

Does your child have any specific medical conditions requiring medical treatment or medication? If yes, please give details, including dosage & frequency :

Does your child take any dietary or nutritional supplements? If yes, please give details, including dosage & frequency :

What type of pain relief (if any) may be given to your child if considered necessary?

Does your child suffer from asthma?

Does your child take any medication for asthma? If so, please give details :

Does your child have any food, drug or other allergies? If so, please give details :

Does your child suffer from any disabilities (physical, visual, hearing or learning) or recognised behavioural problems that could effect their behaviour when training or in competition? If so, please give details :

Does your child have any specific dietary needs?

Is there any other information that the organisers need to be aware of?

Doctor's Name :

Doctor's Telephone Number :

Declarations :

1. I have received details of the activity to be undertaken and give consent for my child to take part in all the activities indicated.
2. To the best of my knowledge, the information given above is complete and accurate
3. I undertake to keep Swim Ulster informed of any changes that may arise in relation to the above information.
4. It may be necessary, in an emergency, for the team staff to have the necessary authority to obtain any urgent treatment which may be required. By signing the declaration below, I am giving consent for any medical or surgical treatment recommended by competent medical authorities to be administered, where it would be contrary to my child’s interest for any delay to be incurred by seeking my personal consent.
5. I am aware of Swim Ulster rules and code of conduct and acknowledge that my child must obey these conditions at all times. Failure to do so my result in sanctions being applied. In the event that such action involvers expense, I accept responsibility to meet any such costs incurred.
6. I am aware that the information declared may be retained by Swim Ulster and will only be made available to those persons who will be responsible for supervising my child but confidentiality of the information will be respected at all times. Swim Ulster Privacy Statement

Signed by Parent / Guardian

Date

An email will be sent to you with further details the week before the clinic.

My Products

NCU Skills Clinic - Breaststroke & Butterfly Skills Clinic - 27.8.26£50.00

Total £0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

National Centre Ulster - Breaststroke & Butterfly Skills Clinic - 27.8.2026

My Products

Payment Methods