Junior Swimming Lessons Register your Interest Form If you are registering your interest for more than one child, please submit a form for each child. By submitting this form, I agree to UoB Sport & Fitness contacting me for the purpose outlined on this form, and that my details will be kept, stored, and used in line with our Privacy Policy, which can be found in the footer of the Sport & Fitness website. You are agreeing that the University may contact you via email, telephone or SMS. You will have the right to change your mind and withdraw consent at any time. By submitting this data, you agree to our Privacy Policy. Full name (child)requiredPlease provide your child’s full nameDate of birth (child)requiredPlease provide your child’s date of birth (DD-MM-YYYY)Sex (child)requiredPlease select the most applicable optionFemaleMaleOtherPrefer not to sayTitle (parent)requiredFull name (parent/guardian)requiredAre you (parent / guardian) currently a member of Sport & Fitness?requiredPlease selectYesNoIf yes, please provide your full membership numberThis can be found on your membership cardDate of birth (parent/guardian)requiredEmail addressrequiredPlease provide a valid email addressTelephone numberrequiredPlease provide a landline or mobile numberHome addressrequiredPostcoderequiredLearn to swim programmerequiredPlease select the level of the swimmer. If you are unsure, we will assess each child during their first lesson to ensure the stage is right for them, or you can look at the expected outcomes of each Swim England Learn to Swim Pathway stage: www.swimming.org/learntoswim/asa-learn-to-swim-awards-1-7/Discovery Duckling (parent & child) – The Discovery Duckling classes are the start of the ‘Learn to Swim’ experience for all children. These classes are perfect for babies, toddlers and pre-school children who are new to swimming. Ideal for gaining water confidence while staying close to adult support. (Age 0−3 years, parent in the water). Duckling (Armbands)– To help toddlers enjoy learning to swim. This stage promotes increased independence and water confidence. (Age 3−4 years). Stage Two (Woggles) – Children will be able to confidently paddle for five metres without adult support whilst using swimming aids.Stage Three– Children will be able to swim five metres without support or swimming aids on their front or back, working towards being able to swim ten metres. Water safety knowledge will also be developed.Stage Four– Children will learn to swim ten metres on their front and back. Swimmers will focus on refining kicking technique for all four strokes. Stage Five – Children will focus on swimming all four strokes. Swimmers must be able to tread water in deep water for one minute with ease to progress to stage six. Stage Six – The swimmer should be able to perform all four strokes at a high standard as required by Swim England at the completion of this stage.Stage Seven – Upon completion of stage 7, the swimmer will be able to perform all four strokes at a high standard with coordinated breathing as required by Swim England.Stage Eight – During this stage, the swimmer will learn to swim 400 metres and perform all four strokes at a high standard with coordinated breathing, as required by Swim England.Stage Nine – This stage will enable the swimmer to swim 800 metres and perform all four strokes including Swim England legal turns to a high standard.Stage Ten – By the end of Stage 10, the swimmer should be able to swim 1500 metres and perform all four strokes including legal turns.Rookie Lifeguard – gives your child the skills they need to be confident in the pool or the sea – which means peace of mind for you.Medical detailsrequiredDoes the swimmer suffer from any medical/behavioural conditions or disability? YesNoIf yes, please give details:Please include details on how any medical conditions affect the child’s swimming/behaviour and if there is any additional support required.Do you currently have another child swimming with us?requiredYesNoIf yes, please give details:Please include their name and member IDFor parents/guardiansrequiredIn the event of any emergency, if I cannot be reached, I hereby give my consent for my child to be transported to hospital and/or given any medical, surgical or dental treatment. In the event of an accident I hereby give my consent for a trained member of staff to administer first aid. I will advise the Swimming Teacher as soon as possible of any change in circumstances as detailed on this form. YesNoParent/Guardian requiredI agree to comply with UoB Sport & Fitness’s Conditions of Use. These can be found in the footer of the UoB Sport & Fitness website. YesNoHow did you hear about us?requiredSchool SwimmingSwimming Referral CardWord Of MouthSocial NetworksOnline SearchSIGN UPThis field should be left blank
