New Starter Medical Form | Little Swimming Co

top of page

Home
Registration & Waiting List
News & Updates
Contact
Services
SEND Zone
Contact
Direct Debit Form
Frequently Asked Questions
Photography Policy & Register
Availability
SEND support form
New Starter Medical Form
Pre School Movers
Missing Lessons
Speak to your Instructor
Terms of Service & Conduct
T&C
Safeguarding
Privacy Policy
Items
More

Use tab to navigate through the menu items.

Swimmers First name*

Swimmers Last Name*

Parent or Guardians Name*

Child's Birthday*

Day

Month

Year

Phone

Secondary Emergency Contact*

Email

Address*

I have read and agree to the terms of service

Medical Conditions (Please check those which impact the swimmer)

Eye Conditions or Injury

Ear and Hearing Conditions

Dental Concerns

Severe Headaches or Migraine

Allergies

Respiratory and Asthma Conditions

Skin Conditions such as Eczema and Dermatitis

Heart Conditions and Chest Pains

Fits, Convulsions, Epilepsy

SEMH

Visual Impairment

Physical Impairment

Muscular and Skeletal Concerns

Neurodevelopmental Conditions

Other

Medical Conditions of a Parent or Guardian who will be attending Parent and Child lessons. (Baby and Pre School)