Learn to swim program

Learn to Swim

1C Mrs. Macquaries Road
The Domain, Sydney, 2000
Enrolment Agreement
If participant is under 18 Years of Age then Enrolment Agreement MUST be completed by Parent /Guardian
FAMILY NAME: _______________________________________________ Father’s Name: __________________________ Mothers Name: ___________________________ Mobile: ________________________________ Address ________________________________________________________________________ Suburb: _______________________________ Postcode: __________ Childs Name:________________________________ DOB: ___/___/____
Medical Information

Does your child have any current injuries? If so please list _____________________________________________________ Is your child currently taking any form of medication? If so please list ___________________________________________ Does your child have any allergies: If so please list ___________________________________________________________ Does your child suffer from or ever suffer from any form of asthma? If so please list ________________________________ Does your child use any for of Ventolin or puffer: Yes / No Description _________________________________ Does your child suffer from or ever suffered from any ear disorders? If so please list _________________________________ Has your child/ren ever had an epileptic seizure? If so please list ____________________________________________________ Does your child have any other relevant medical or environmental considerations? ___________________________________ In my opinion, there is no medical reason why my child/ward should not take part in the Andrew Boy Charlton Swimming Program. I understand that all safety precautions will be observed, and will endeavour to follow all direction to the best of my child’s ability.
Photo Consent:
I/We understand that by signing this form I am granting Belgravia Leisure and the Centre permission to use any photographs of my child for the
purpose of advertising and promotion and that Belgravia Leisure and the Centre agree not to use any photograph in a manner that may not be deemed
adverse, or defamatory to my/our child/ren.
I/We, accept the Terms and Condition as part of the agreement of my/our child being enrolled into the Andrew Boy Charlton Swim School. Signature: _________________________________________ (Parent/Guardian if participant is under 18 years of age)
Office Use Only:
Acceptance of Form:
Staff Name: __________________________ Signature: _____________________ Date: ___/___/___ Computer Entry: Staff Name: __________________________ Signature: _____________________ Date: ___/___/___
Learn to Swim


All payments MUST be made in full at the time of booking Telephone bookings will be accepted with payment and forms completed within 5 days Select you classes carefully as a no refund policy applies Every effort will be made to adhere to the timetable but Belgravia Leisure reserves the right to change and alter classes as necessary Private Lessons are subject to availability and must be booked and paid for on a term basis All Swim School Fees include admission for participant and family You must notify The Andrew (Boy) Charlton Pool of any changes to you details and other relevant information pertaining to your enrolment Management may cancel your enrolment at its discretion All participants must be supervised by a parent or guardian for the duration of their lesson and whilst they remain in the facility Belgravia Leisure is bound by the Privacy Act.
Make Up Lesson Policy

Make up lessons are only given in the event of an illness. A DOCTOR’S CERTIFICATE MUST be provided and a prompt courtesy call to the Centre provided. This applies for ONE lesson only. 2. For extended illnesses a Doctor’s certificate MUST be cited in order for your booking to be held. Any exceptions to the above must be approved by the Learn to Swim Coordinator or the Centre Management. Makeup lessons must be taken during the Learn to Swim program timetable. THERE WILL BE NO REFUNDS. I/We consent to my child involvement in The Andrew (Boy) Charlton Swim School and understand the conditions of booking. I do not hold Belgravia Leisure, their Centre's, staff or any other people involved in these businesses responsible for, and I indemnify them from all liability for all accidents, personal injury, loss or damage whether consequential or otherwise, and whether or not such injury, loss or damage is reasonably foreseeable, which may occur as a result of my child’s attendance at the centre. I irrevocably authorise medical treatment as they see necessary at my expense. I understand children must not be left at the centre without parent or guardian supervision and will ensure such supervision of my child whilst at the CARERS OF PARTICIPATES MUST REMAIN WITHIN THE CENTRE

Source: http://www.akac.com.au/uploads/files/abc_lts.pdf


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