Barnet Premier Swim

Adult Swimming Lesson Enrolment Form

Please complete all sections to enrol yourself in swimming lessons.

After submitting, your completed enrolment form will be emailed to Barnet Premier Swim.

Swimmer Details

Full name Date of birth

Gender

Male Female

Swimming ability Agreed lesson day Agreed Start Date (if applicable) If a start date has not yet been agreed, please write a short note.

Contact Details

Address Postcode Telephone number Email

Emergency Contact Details

Emergency contact full name Emergency contact telephone number

Medical and Additional Information

Details of any disabilities, allergies, illnesses, injuries, or additional needs which may affect your participation in swimming lessons. Please write N/A if not applicable.

Photo Permission

Do you give permission for photos to be taken and used for promotional purposes?

Yes, I give permission No, I do not give permission

Date Completed

Date completed

Declaration

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