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JUNIOR SQUAD SWIMMING GEELONG
Please complete this form to Book an ASSESSMENT or ENQUIRE about our
Junior and Adult SQUAD
programs at Geelong Grammar School, Handbury Centre for Wellbeing, Foreshore Rd, Corio
Bookings are now being taken for our Teen-Fit, Junior, Development and Adult Squad programs.
Placement in our squad program is usually subject to a FREE assessment
(no obligation)
to determine correct level.
All H2O programs place great emphasis on fitness, drills, skills, technical proficiency, stroke development, correction and improvement.
Please give us some details below so we can contact you to discuss options and answer any questions you might have ...
*
Indicates required field
What can we help you with ?
*
1. SQUAD ASSESSMENT
2. SQUAD ENQUIRY (may still need assessment)
Parents Name
*
First
Last
Mobile Phone Number
*
Preferred Email
*
Home Address: Street, Suburb, Postcode
*
EMERGENCY SECONDARY CONTACT NAME
*
First
Last
Please list the name of a secondary emergency contact
EMERGENCY CONTACT RELATIONSHIP:
*
EMERGENCY NUMBER
*
How many swimmers are there?
*
1
2
3
Please tell us about the Squad Swimmers and their Standards below...
1. TEEN-FIT
- recreational squad, no other requirements
2. JUNIOR
- must swim a
minimum of 2 times per week
& be registered with MH2O Swimming Club
2. DEVELOPMENT
- must swim a
minimum of 3 times per week
& be registered with the MH2O Swimming Club
4. STATE
- pending future interest
5. ADULT
- 18 years and over, must be able to swim a minimum of 100m Freestyle plus 1 other stroke
Swimmer 1 Name
*
Swimmer 1 Date of Birth
*
Swimmer 1 Medical Conditions - Any pre-existing illness, injury or learning difficulty that may affect learning &/or interaction with their teacher or other swimmers?
*
Swimmer 1 Standard - see above
*
SQUAD - new to squad, first time
SQUAD - past or present squad swimmer
SQUAD - am a swim club member
Swimmer 1 is interested in ?
*
TEEN-FIT
JUNIOR
STATE
DEVELOPMENT
ADULT
- not sure, I need an Assessment -
Swimmer 2 Name
*
Swimmer 2 Date of Birth
*
Swimmer 2 Medical Conditions - Any pre-existing illness, injury or learning difficulty that may affect learning &/or interaction with their teacher or other swimmers?
*
Swimmer 2 Standard - see above
*
SQUAD - new to squad, first time
SQUAD - past or present squad swimmer
SQUAD - am a swim club member
Swimmer 2 is interested in ?
*
TEEN-FIT
JUNIOR
DEVELOPMENT
STATE
ADULT
- not sure, I need an Assessment -
Swimmer 3 Name
*
Swimmer 3 Date of Birth
*
Swimmer 3 Medical Conditions - Any pre-existing illness, injury or learning difficulty that may affect learning &/or interaction with their teacher or other swimmers?
*
Swimmer 3 Standard - see above
*
SQUAD - new to squad, first time
SQUAD - past or present squad swimmer
SQUAD - am a swim club member
Swimmer 3 is interested in ?
*
TEEN-FIT
JUNIOR
DEVELOPMENT
STATE
ADULT
- not sure, I need an Assessment -
1. ASSESSMENT
(approx. 10 minutes)
PREFERENCES BOOKING
I would like to book a Squad Assessment at The Goodfellow Aquatic Centre on a...
*
MONDAY at Geelong Grammar (HCW)
TUESDAY at Geelong Grammar (HCW)
THURSDAY at Geelong Grammar (HCW)
2. TRAINING DAYS PREFERENCES
Please view our individual Squad Timetables to see the sessions on offer for each squad
Swimmer 1 Training Days (please tick preferences) ?
*
MONDAYS
TUESDAYS
WEDNESDAYS
THURSDAYS
FRIDAYS
SATURDAYS
Swimmer 2 Training Days (please tick preferences) ?
*
MONDAYS
TUESDAYS
WEDNESDAYS
THURSDAYS
FRIDAYS
SATURDAYS
Swimmer 3 Training Days (please tick preferences) ?
*
MONDAYS
TUESDAYS
WEDNESDAYS
THURDAYS
FRIDAYS
SATURDAYS
To help us better understand what level your swimmers will fit into, please tell us ...
Are you a CURRENT Member of a Swimming Club
*
YES, please name your club below
NO
Swimming Club name ?
*
3. ENQUIRIES
Any other comments or questions ?
*
PLEASE TICK THE BOX BELOW...
*
I have read and completed where relevant the Medical Information section and agree to the H2O Swimming Works Terms & Conditions as displayed on the H2O website Homepage, Terms & Conditions webpage. I further also give my permission for my child/ren photo/s to be displayed at the pool or on the H2O website for promotional purposes only.
Submit
