Adult Swimming Lessons

Please State Your Preference for

First Name

Surname

Gender

Male Female

Date of Birth

Mobile Phone Number

Emergency Contact Name

Emergency Contact Number

Disabilities (Physical or Hidden) ie: Asthma, Diabetes, Epilepsy, Heart Condition, Autism etc.. (Please enter ‘None’ if not applicable)

Level of Ability

Beginner

Non Swimmer – Fear of water – Can’t put face under water – Can’t float in horizontal position by themselves (unaided)

Intermediate

Has confidence in the water – Can float by themselves (unaided) – Can’t swim in proper stroke

Improver

Can swim front crawl or breaststroke one full length of pool (20m) – Wants to learn new stroke

Advanced

Can swim lengths comfortable but want to improve technique – To improve technique, speed, distance and resistance training

Application form