Application for Membership

SWIMMER DETAILS

NB: Please use one application per swimmer.

Name of Swimmer: (required)  

Sex: (required)  

Date of Birth: (required)     Age: (required)  

Address: (required)

Previous Swimming Experience: (required)

Are you or have you been a member of another swim club? (required)    Yes No

If Yes please provide details (Club Name etc.):  

PARENT / GUARDIAN CONTACT DETAILS

Name of Parent / Guardian: (required)  

Home Phone:  

Mobile No: (required)  

Email Address: (required)  

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

Please enter your unique verification code
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Notes

  1. All members must complete this application form to register with the Club.
  2. All relevant codes of conduct and club policies must also be signed and adhered to
  3. New members must also complete and sign the Swim Ireland Membership Form.

NB: If Membership of Asgard Swimming Club is granted then you accept that as a parent / guardian you have a legal responsibility to pay fees owed by your child. This obligation also applies even if the swimmer leaves the Club with accrued debts.