EmailMe Form - Baines Endowed

Swimmer Name *

First Last

Would you like your learner to take part in the upcoming swim trials/gala? *

My Swimmer is in Yr *

Please select from the dropdown

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

My Swimmer would like to take part in the following events;

Parent/Guardian Email Address *

Today's Date *

DD / MM / YYYY