PRIMROSE POOL ENROLMENT AND MEDICAL HISTORY FORM Primrose pool, Primrose Lane, Ramsey, Harwich, CO12 5NB Swimmers name Swimmers Date of Birth Gender Prefer not to say Male Female Previous swimming awards Contact name Contact Number - Land Line (Optional) Contact Number - Mobile Home Address Email Address Day Monday Tuesday Wednesday Thursday Saturday Time Medical information - Is there anything that the swimming teachers should be aware of in relation to swimming and tuition? No Yes If Yes, please give details Term Term 1: Monday 6th January 2020 - Sunday 15th March 2020 Term 2: Monday 16th March 2020 - Sunday 24th May 2020 Term 3: Monday 25th May 2020 - Sunday 2nd August 2020 Term 4: Monday 3rd August 2020 - Sunday 11th October 2020 2019 Term 5: Monday 12th October 2020 - Sunday 20th December 2020 Select Payment Method BACS Cheque Details for BACS payment: Account number 00100758. Sort Code 826315 Ref: swimmers name Cheques made payable to swim2swim Ltd with swimmers’ name on back I confirm I have read and agree to all the pool rules and terms and conditions which can be found by clicking the link below I give permission for Swim2Swim to contact me regarding swimming lessons via email, text or phone I understand that babies and children who are not toilet trained must wear a snug fitting aqua nappy; nappies must be taken home. By returning this form I confirm I have read and answered the above, to the best of my ability and agree to inform swim2swim of any changes. Pool Rules and Terms & Conditions