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Intensive 5 day fast track Enrolment form
Monday 13th to Friday 17th January 2025 (5 days)
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* Indicates required question
Email
*
Your email
Surname (swimmer)
*
Your answer
Parent/s name/s
*
Your answer
Contact number/s
*
Your answer
Child's name
*
Your answer
DOB
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Prefer not to say
Other:
Current ESS Swimmer?
*
Yes
No
Suggested level
https://www.elthamswim.com.au/wp-content/uploads/2021/02/LEVELPOSTER.pdf
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Preferred time
*
7:30-8:30 squad session (Level 15 and above only)
8:30
9:00
9:30
10:00
10:30
Required
2nd Child's name
Your answer
DOB
MM
/
DD
/
YYYY
Gender
Male
Female
Prefer not to say
Other:
Clear selection
Current ESS Swimmer?
Yes
No
Clear selection
Suggested level
https://www.elthamswim.com.au/wp-content/uploads/2021/02/LEVELPOSTER.pdf
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Clear selection
3rd Child's name
Your answer
DOB
MM
/
DD
/
YYYY
Gender
Male
Female
Prefer not to say
Other:
Clear selection
Current ESS Swimmer?
Yes
No
Clear selection
Suggested level
https://www.elthamswim.com.au/wp-content/uploads/2021/02/LEVELPOSTER.pdf
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Clear selection
4th Child's name
Your answer
DOB
MM
/
DD
/
YYYY
Gender
Male
Female
Prefer not to say
Other:
Clear selection
Current ESS Swimmer?
Yes
No
Clear selection
Suggested level
https://www.elthamswim.com.au/wp-content/uploads/2021/02/LEVELPOSTER.pdf
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Clear selection
Medical Terms & Conditions
A Parent / Guardian is expected to be present at the swimming school whilst your children are attending. In the event that a Parent / Guardian is not present, I authorise Eltham Swimming School Management to obtain any medical treatment as is deemed necessary. Should you not agree, a Parent / Guardian must always be present whilst the children are in attendance.
*
Yes
No
Photo/Video
We take photographs & video at our centre for, encouragement of the children, internal training and promotion.
Please sign below if you do not object to your children being included in photos or video.
*
Yes
No
Membership Terms & Conditions
I have read and agree to the Membership Terms & Conditions.
https://www.elthamswim.com.au/terms-and-conditions/
*
Yes
No
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