EmailMeForm
MEDICAL CREDIT REQUEST - SWIM PROGRAMS
Complete and submit this form if your student missed lessons / sessions due to medical reasons. A valid medical certificate from a medical practitioner stating the students name and covering all dates of the missed lessons /sessions must be attached to this form in order for it to be processed. A team member will email you within 3 business days of your form submission to confirm your credit.
Parent / guardian first name
*
This must be someone listed as a responsible person of the student's swim program account
Parent / guardian last name
*
This must be someone listed as a responsible person of the student's swim program account
Contact number
*
Email
*
Student full name
*
Date medical absence started
*
DD
/
MM
/
YYYY
Select the date of the first missed lesson / session due to medical absence
Date medical absence ended
*
DD
/
MM
/
YYYY
Select the date of the last missed lesson / session due to medical absence
Attach medical certificate here
*
Add File
Attach the students medical certificate here
