REGISTRATION FORM - WESTERN AQUATIC SWIMMING ACADEMY

1

Are you registering for your child or as an adult (18+)?* This field is required.Child/Adult Registration

I am registering for my child

I am registering for myself (18+)

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Applicant’s Name* This field is required.

First Name

Last Name

3

Applicant’s Gender* This field is required.

Male

Female

4

Applicant’s Date of Birth* This field is required.

Date

5

Applicant’s Phone Number* This field is required.

Please enter a valid phone number.

6

Applicant’s Place of Birth* This field is required.

7

Applicant’s Address

8

Applicant’s Email* This field is required.

example@example.com

9

Applicant’s Medical conditions (if applicable)* This field is required.

10

Applicant’s Swimming Experience* This field is required.

No swimming experience

Little to no swimming experience

Advanced swimming experience

11

Is he/she a new or returning student?* This field is required.

New student

Returning student

12

Are you a new or returning student?* This field is required.

New student

Returning student

13

Which location would you prefer?* This field is required.West/ East

Shoppes of Maraval (SOM)

Centre of Excellence (COE)

14

Which day would you prefer to have swimming classes?* This field is required.(Shoppes of Maraval ONLY)

15

Which day would you prefer to have swimming classes?* This field is required.(Centre of Excellence ONLY)

16

How did you find out about Western Aquatic Swimming Academy?* This field is required.

Online

Flyer

Referral

Other

17

Mother’s Name (Guardian #1)* This field is required.

First Name

Last Name

18

Mother’s Phone Number* This field is required.

Please enter a valid phone number.

19

Mother’s Email

example@example.com

20

Mother’s Address

21

Father’s Name (Guardian #2)* This field is required.

First Name

Last Name

22

Father’s Phone Number* This field is required.Yh

Please enter a valid phone number.

23

Father’s Email

example@example.com

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Father’s Address

25

Name of Emergency Contact * This field is required.

First Name

Last Name

27

Phone Number of Emergency Contact #1* This field is required.

Please enter a valid phone number.

28

Phone Number of Emergency Contact #2* This field is required.

Please enter a valid phone number.

29

* This field is required.Western Aquatic Swimming Academy Customer Policies Effective: January 2026. Welcome to Western Aquatic Swimming Academy! We are committed to providing a positive and safe learning environment for all our students. To ensure a smooth and enjoyable experience for everyone, we kindly ask that all customers adhere to the following policies. 1. Enrollment and Registration - Registration Process: All students must complete the registration form before attending any lessons. This includes providing emergency contact information and any relevant health details. - Class Placement: Placement in classes is based on age, skill level, and availability. Our instructors may adjust placement as needed to ensure the best learning environment for each student. - Waiting Lists: If a class is full, students will be placed on a waiting list and notified when a spot becomes available. 2. Payment and Fees - Payment Methods: Payments for lessons are due at the first class, and can be made via cash or linx. 3. Attendance and Cancellations - Attendance: Students are expected to attend their scheduled lessons. Consistent attendance is essential for progress. - Holidays: There will be no swimming classes on Public Holidays. - Cancellations by Parents/Guardians: If a student is unable to attend a lesson, please notify us at least 2 hours in advance. - Cancellations by the School: In the event that a class is cancelled by Western Aquatic Swimming Academy, we will offer a make-up class. In extreme cases (e.g., severe weather, pool closer), classes may be cancelled with no make-up available. - Make-Up Lessons: Make-up lessons are available only in emergencies if notified of an absence before the class with only 2 make up for the term, subject to availability. 4. Health and Safety Health Conditions: Parents/guardians must inform us of any pre-existing medical conditions or concerns about their child’s health before attending classes. If a student is feeling unwell or injured, they should not attend the lesson. - Proper Attire: All students must wear appropriate swimwear (No Cotton), such as swimsuits or swim pants, swim caps are required for swimmers with long hair and arm bands for swimmers 2 ½-7years without swimming experience. Please avoid wearing jewellery or accessories that could pose a risk in the water or get lost. - Supervision: We request that parents supervise their child before and after lessons as needed. 5. Behaviour and Conduct - Respectful Behaviour: We expect all students to exhibit respectful behaviour towards instructors and fellow swimmers. Disruptive behaviour may result in temporary time out if continued removal from the class. - Parent Conduct: Parents and guardians are asked to refrain from interacting with the instructor and the student during lessons, as this can disrupt the learning process. Please ensure your child understands the importance of listening to their instructor. 6. Photography and Media Consent Photography Policy: We may take photos or videos during lessons for promotional purposes, social media, or internal use. If you do not wish to have your child’s image used, please inform us in writing prior to enrolment. 7. Refunds and Termination - Refunds: We do not offer refunds for missed lessons or if you choose to discontinue the swimming class, refunds are only given for medical purposes accompanied by the medical report. - Termination of Services: We reserve the right to terminate a student’s enrolment if their behaviour is deemed inappropriate, or if they consistently fail to meet payment requirements. 8. Liability - Liability Waiver: By enrolling in our program, you acknowledge that you understand the inherent risks associated with swimming. Western Aquatic Swimming Academy is not responsible for any injuries that may occur during lessons. 9. Communication - Contacting Us: We encourage open communication. If you have any questions or concerns, please contact us at 868 732-5916 or 868 346-6952. - Updates and Notices: Important updates, such as schedule changes or cancellations, will be communicated via What’s App group message, Facebook or Instagram. Thank you for choosing Western Aquatic Swimming Academy for your swimming education. We look forward to working with you and your child to build a safe and enjoyable learning experience!