Midlands Para-Swimming Training Programme 2023/2024 - Swimmer Sign Up

The Midlands Para-Swimming Training Sessions for the 2023/24 season are taking place on Sunday 7th January 2024, Sunday 24th March 2024 and Sunday 9th June 2024.

Eligible athletes:

Member of a Swim England East Midlands or Swim England West Midlands club who are not on a World Class Programme
9 years of age/over as of 31st December 2024
Swimming regularly and can swim 100m or more across multiple strokes (where impairment allows)
Have a classification including S64, are on the classification waiting list (S99) or have an eligible impairment and wish to start the classification process
Swimmers with a Hearing Impaired classification (S15) or wishing to begin the process of classification with GB Deaf Swimming Club

To sign up to the session please complete the following survey and make payment via BACS as detailed below.

Joining before session 1 - £45
Joining before session 2 - £35
Joining before session 3 - £20

Name: Swim England East Midlands Ltd
Sort Code: 30-96-26
Account Number: 77761068

Please use the reference ‘PTS and your surname’ when making payment

Information on this form will be shared with the delivery team and all data is held on areas that require a password or VPN secure access.

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* 1. Full name

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* 2. Date of Birth

Date of Birth

Date

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* 3. Swim England Membership Number
You can check membership number below
https://www.swimming.org/swimengland/club-member-check/
Please note club train swimmers are welcome to attend the pool session element only however swimmers will will require club compete membership to be assessed for classification attendance

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* 4. Name of Club

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* 5. Name of coach

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* 6. Please provide a correspondence email address
(Parent / Guardian email for under 18s)

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* 7. Please provide your phone number
(Parent / Guardian phone number for under 18s)

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* 8. Classification Type

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* 9. Please give details of any medical conditions or allergies

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* 10. Please give details of any medication currently prescribed. Please indicate if the athlete will be carrying this medication at the sessions
(please ensure any medication is clearly labelled with the athletes name)

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* 11. Please give details of any injury or illness which may impact the athlete during the sessions

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* 12. Please make us aware of any educational/behavioural requirements, indicating details of any reasonable adjustments that will need to be taken into account

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* 13. Medical declaration
Please confirm as parent/guardian of the above named athlete that you give permission for the Team Manager to give immediate necessary authority on your behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to your son/daughter's interest, in the doctors medical opinion, for any delay incurred by seeking your personal consent.

Yes

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* 14. Emergency Contact 1

Name *

Relationship to athlete

Phone Number *

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* 15. Emergency Contact 2

Name *

Relationship to athlete

Phone Number *

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* 16. Photo release
You give your permission for photographs to be used for marketing material, publication and website (including our social media channels).
If you have any objection to these images of your child appearing please inform us below

Yes

Other (please specify)

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* 17. I confirm by submitting this survey that (please tick):
Code of Conduct

I agree to the athlete code of conduct

Midlands Para-Swimming Training Programme 2023/2024 - Swimmer Sign Up

Question Title

* 1. Full name

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* 2. Date of Birth

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* 4. Name of Club

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* 5. Name of coach

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* 6. Please provide a correspondence email address(Parent / Guardian email for under 18s)

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* 7. Please provide your phone number(Parent / Guardian phone number for under 18s)

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* 8. Classification Type

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* 9. Please give details of any medical conditions or allergies

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* 10. Please give details of any medication currently prescribed. Please indicate if the athlete will be carrying this medication at the sessions(please ensure any medication is clearly labelled with the athletes name)

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* 11. Please give details of any injury or illness which may impact the athlete during the sessions

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* 12. Please make us aware of any educational/behavioural requirements, indicating details of any reasonable adjustments that will need to be taken into account

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* 14. Emergency Contact 1

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* 15. Emergency Contact 2

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* 16. Photo releaseYou give your permission for photographs to be used for marketing material, publication and website (including our social media channels). If you have any objection to these images of your child appearing please inform us below

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* 17. I confirm by submitting this survey that (please tick):Code of Conduct

* 6. Please provide a correspondence email address
(Parent / Guardian email for under 18s)

* 7. Please provide your phone number
(Parent / Guardian phone number for under 18s)

* 10. Please give details of any medication currently prescribed. Please indicate if the athlete will be carrying this medication at the sessions
(please ensure any medication is clearly labelled with the athletes name)

* 16. Photo release
You give your permission for photographs to be used for marketing material, publication and website (including our social media channels).
If you have any objection to these images of your child appearing please inform us below

* 17. I confirm by submitting this survey that (please tick):
Code of Conduct