Family Enrolment Form Point Cook Please enable JavaScript in your browser to complete this form.STUDENT(S) DETAILSSelect Number of Children registeringOneTwoThreeFourName Child 1 *Date Of Birth *Gender Child 1 *FMSelect Level (Child 1)PLEASE SELECTToddler BeginnerToddler AdvancedBeginner 1Beginner 1-2Beginner 2Level 1Level 1-2Level 2Level 3Level 4Level 5Does your child(ren) have any medical conditions eg. Asthma? If yes, please list:Does your child(ren) have any learning difficulties? If yes, please list:Name Child 2Date Of BirthGender Child 2FMSelect Level (Child 2)PLEASE SELECTToddler BeginnerToddler AdvancedBeginner 1Beginner 1-2Beginner 2Level 1Level 1-2Level 2Level 3Level 4Level 5Does your child(ren) have any medical conditions eg. Asthma? If yes, please list:Does your child(ren) have any learning difficulties? If yes, please list:Name Child 3Date of BirthGender Child 3FMSelect Level (Child 3)PLEASE SELECTToddler BeginnerToddler AdvancedBeginner 1Beginner 1-2Beginner 2Level 1Level 1-2Level 2Level 3Level 4Level 5Does your child(ren) have any medical conditions eg. Asthma? If yes, please list:Does your child(ren) have any learning difficulties? If yes, please list:Name Child 4Date of BirthGender Child 4FMSelect Level (Child 4)PLEASE SELECTToddler BeginnerToddler AdvancedBeginner 1Beginner 1-2Beginner 2Level 1Level 1-2Level 2Level 3Level 4Level 5Does your child(ren) have any medical conditions eg. Asthma? If yes, please list:Does your child(ren) have any learning difficulties? If yes, please list: Level Description Toddler Beginner: Your child is between 6-18 Months. (Parent/Child class) Toddler Advanced: Your child is between 18 Months to 3 Years. (Parent/Child class) Beginner 1: Your child is 3-4 years old and learning the fundamentals of swimming such as blowing bubbles, paddling, and kicking. Beginner 1-2: Your child is 5 years + who are learning the fundamentals of swimming. Note: Children that complete this level move straight to a Level 1. Beginner 2: Your child is 4—6-year-old and can submerge, blow bubbles and paddle & kick for 2m unassisted. Level 1: Your child can float independently on their back, maintain a streamlined body position and paddle & kick with a pop-up breath for 5m. Comfortable to jump into deep water and swim to safety. Level 1-2: Your child can torpedo in a streamlined body position, swim freestyle using an effective freestyle arm action (with pop up breath) and swim on their back unassisted. Level 2: Your child can torpedo on their front and back in a streamlined position for 15 metres, swim freestyle with correct side breathing for 15 metres, swim backstroke for 15 metres and tread water/scull for 60 seconds. Level 3: Your child can swim freestyle, backstroke and survival backstroke for 25 metres all with correct technique. They can also breaststroke kick on their front with flotation aid for 10 metres. Level 4: Your child can swim freestyle and backstroke for 50 metres, swim breaststroke for 25 metres with correct technique and dolphin kick for 15 metres. Level 5: Your child can swim freestyle, backstroke and breaststroke for 100 metres with correct technique and swim butterfly for 25 metres. PARENT / GUARDIAN DETAILSParent/Guardian 1 *(Full Name)Mobile - Parent 1 *Email - Parent 1 *Parent/Guardian 2(Full Name)Mobile - Parent 2Email - Parent 2Parent.Guardian 2Address *Address Line 1CityState / Province / RegionPostal CodePreferred days *MondayTuesdayWednesdayThursdayFridaySaturdaySundayMonday Preferred timesMornings: 8.30am – 11amAfternoons: 3.45pm – 7.15pmTuesday Preferred timesMornings: 8.30am – 11amAfternoons: 3.45pm – 7.15pmWednesday Preferred timesMornings: 8.30am – 11amAfternoons: 3.45pm – 7.15pmThursday Preferred timesMornings: 8.30am – 11amAfternoons: 3.45pm – 7.15pmFriday Preferred timesMornings: 8.30am – 11amAfternoons: 3.45pm – 7.15pmSaturday Preferred timesWeekends: 8.30am – 1.00pmSunday Preferred timesWeekends: 8.30am – 1.00pmNotesDo you give consent to Saltwater Swim School using your child’s photograph/and or video in promotional materials or social media platforms? *YesNoPlease tickMedical Authority and Terms & Conditions Agreement Term fees must be paid in full prior to the commencement of each term program. In the event of enrolment cancellation after the Term has commenced, a fee equal to 2 lessons will be charged and is non-refundable. In the event of absence, make up lesson(s) are available and must be made up within the same term, this is subject to availability - there are no credits or refunds on missed lessons or un-used make-ups. A minimum of 60 minutes prior notice is required for any absences and must be notified either via Customer Portal or contacting the centre before participants class starts. Should a make-up class be booked but not attended, the lesson is therefore forfeited. To prevent the spread of cryptosporidium and illness, if a child has suffered from gastro, diarrheal, vomiting or stomach upsets please keep them home from swimming, and we will attempt to find make up classes for them when they are well. Saltwater Swim Schools reserves the right to change classes, instructors or move students if the need arises. We do however strive to maintain consistency where possible. As a respect of privacy, photography is not allowed, unless consent is given by other swimmers, parents/guardians and management. Children are not to enter the water prior to their lesson starting until directed to do so by their instructor. All children must also exit the water when directed to do so by their instructor. A parent/guardian is required to remain on the pool premises at all times during their child(ren’s) class. INDEMNITY CLAUSE (please read carefully) Saltwater Swim Schools (“SWSS”) takes no responsibility or liability for accidents or injuries that occur within or outside the swimming school premises. I hereby give full permission that my child can take part in the swimming programs presented by Saltwater Swim Schools and indemnify Saltwater Swim Schools, it’s owners and employees of SWSS, and hold it harmless against all loss or damage that it might sustain from any accident, sickness or injury that might occur whilst on the SWSS premises. I consent for the staff at Salt Water Swim School to provide medical assistance as deemed necessary in the event of any illness or accident which may occur whilst attending the swimming school and agree to meet any medical expenses incurred. I have read and fully understand the Medical Authority, Make Up Policy, Indemnity and Terms & Conditions of lessons & enrolment and I agree to abide by all of its conditions noted above. I, *FirstLastthe parent/guaridianof *consent for the staff at Saltwater Swim School to provide medical assistance as deemed necessary in the event of any illness or accident which may occur to my child(ren) whilst attending the swimming school and agree to meet any medical expenses incurred. I have read and fully understand the Medical Authority, lesson make up policy and Terms & Conditions of lesson enrolment and I agree to abide by all of its conditions.Signature Clear Signature DateCommentSubmit
