Forename/Given name *
Surname/Family name *
Date of birth *
Swim England sex *---MaleFemale
When we register you with Swim England, we only have a choice of male or female for sex.
Contact 1 name *
Contact 1 telephone *
Contact 2 name
Contact 2 telephone
Detail any regular medication taken
The club may wish to take photographs of individuals and groups of swimmers, which may include you. All photographs will be taken and published in line with the Swim England Photography Policy. The club requires consent to take and use photographs. You have a right to refuse agreement to being photographed. Please indicate your permission below. Please note you can withdraw your consent in writing to the club Welfare Officer at any time should you wish to do so.
Photos may be used on secure club websiteYesNo
Photos may be included in newspaper articlesYesNo
Filming for training purposesYesNo
Photos by professional photographer at eventsYesNo
Country of international representation
Name of any other swimming club you are a member of
I can be contacted by emailYesNo
I can be contacted by postYesNo
I have read the Club's Swimwear and Privacy Policies and agree to abide by the Club’s Code of Conduct.
I declare that I am fit enough to swim and that I have taken and I am following any medical advice given to me in respect of this.
I will report any relevant health issues to the coach at each swim session.
At any Club sessions and swim camps you can wear: