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Robbie Phillips B.A., F.I.S.R.M (Dip)., D.S.T.A. M.I.S.P.A.L.
Gaynor Phillips S.R.N.

7 SUNNYCROFT ROAD,

 BAGLAN,

PORT TALBOT SA12 8TB.

Phone/Fax: 01639 774041

info@sensitivewatersolutions.co.uk

'POOLING KNOWLEDGE'

Swim School Application

Name
Address
Postcode
Telephone

Email

Age
Sex
Male Female
Height
Date of birth
Water Confidence Details
Face in water
Complete non swimmer
  Yes No
Can swim with aids
  Yes No
Approximate distance (metres)
 
Can swim without aids
  Yes No
Approximate distance (metres)
 
Tread water
  Yes No
Float
  Yes No
If a swimmer, list below distance and strokes (advanced)
Breast.........Backcrawl  .........Frontcrawl  
Type of Child
Preferred times - List times preferred
Llangatwg
Friday 5pm - 8pm
Saturday 9am - 12.00pm
Sunday 9am - 12.00pm
Llangatwg (Beginners 3.5 - 5)
Monday 4.30pm - 6.00pm
Llangatwg (Beginners 3.5 - 5)
Thursday  4.30pm - 6.00pm
For children 5 and under who are complete non swimmers, we strongly recommend that you enrol on beginners class (Mon & Thurs)
A CHEQUE MUST BE SENT WITH PRINTED APPLICATION FORM FOR £65.00
Any medical conditions?

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