EmailMe Form - Royles Brook Primary School Swim Form

Swimmer Name *

First Last

Has Your Swimmer Had Lessons Before? *

My Swimmer is in Yr *

IF yes -Please select the most recent badge/stage they attained. If you can't remember or are unsure - please select 'Not Sure' If no previous lessons, select N/A *

Has your swimmer ever had a negative experience of water/lessons or has any anxiety toward swimming lessons/water? *

IF your swimmer has any anxiety or experienced negative situations in water/lessons please describe as accurately as possible your swimmer's experience and potential concerns you or they may have? Please leave blank if not applicable.

Medical considerations: Does your swimmer require medication or special considerations towards a medical condition which may be effected by exercise? *

I am happy for my swimmer to attend swimming lessons beginning in 2026/7. *

Parent/Guardian Email Address *

Today's Date *

DD / MM / YYYY