Club Membership Registration

Swimmer Details

Swimmer Name (required)     Sex (required)  

Age (required)   Date of Birth (required)

Email Address  

Address (required)

Contact Information

Name & Telephone No (Parent / Guardian) (required)

Name (required)     Telephone # (required)  

Email Address (required)     Note: For persons under 18 years this address will be used as the primary contact

Relationship:  

Name & Telephone No (Parent / Guardian (optional)

Name     Telephone #  

Relationship:  


Emergency Contacts

Name (required)  

Mobile Number (required)  

Relationship:  


For Swimmers under 18 only

Please indicate if there is any relevant medical information that our coaching staff should be made aware of.

(If yes, we will endeavour to arrange a suitable time for you to meet with your child’s coach to discuss further)

Parental / Guardian Consent

I hereby consent to Asgard Swimming Club administering appropriate medical attention to the above named swimmer in the event of illness or injury whist participating in club activities.

I hereby consent to my child participating in the activities of Asgard Swimming Club

Name (required)  

Relationship to Swimmer::  

Date (required)   [date* DATE date-format:dd/mm/yy]

Please enter your unique verification code
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IMPORTANT

  1. By completing this application for membership you agree to abide by the Safeguarding Children Policies and Procedures and rules as set out by Swim Ireland and Asgard Swimming Club
  2. You also agree to abide by the code of conduct as laid out by Swim Ireland and Asgard Swimming Club