Academy Starts/Dives Clinics Application

Academy Starts/Dives Clinic Booking Form


Please complete one form per swimmer.
The form must be completed by a parent or guardian.
No bookings are confirmed until the completed form and full payment are received. Please check the form carefully before sending. Mistakes can delay your application and may mean your child misses out on a space on the clinic.
All boxes marked with an asterisk must be completed.



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    1. BOOKING DETAILS

    Please complete the details of your booking below.
    Clinics cost £40 each.

    Clinic Name:

    Date:

    Time:

    Cost £:

    Clinic Name:

    Date:

    Time:

    Cost £:

    Clinic Name:

    Date:

    Time:

    Cost £:

    Clinic Name:

    Date:

    Time:

    Cost £:

    Please enter the total cost of all clinics requested :Total Cost £* :

    Please note: No place is guaranteed as bookings are accepted on a first-come-first-served basis.
    After submitting this form am email will be sent within seven days, either to confirm the reservation, or to inform you that the clinic/camp is full.
    If a space is available on the clinic/s or camp/s you have requested then we will send a request for payment to you by email.
    Once you receive an email from us with the word ‘CONFIRMATION’ in the subject headline, you will know that the place is confirmed.
    Please DO NOT send payment until we request it. Thank you

    2. SWIMMER’S DETAILS

    Please enter the swimmer’s details below:-

    First Name*     Surname*     Preferred Name

    Date of Birth*     Please confirm year of birth*

    Gender*

    Squad*

    Number of hours of training swimmer undertakes each week*

    To find your Swim England Membership number please click the link to the Swim England website in the box at the top of the page.
    Swim England Membership Number*

    3. PARENT/GUARDIAN DETAILS

    Please enter the your details below:-

    First Name*              Surname*

    Relationship to swimmer*

    Address*

    PostCode*

    Your Email*
    Yahoo emails will go to spam, so please provide a second non-Yahoo email ONLY IF your main email is with Yahoo.
    Second Email:

    Please note that the Club uses email to communicate therefore an up to date email address is essential.
    This must include the email address of the person responsible for payment.

    First Mobile Number*              Second (different) Mobile Number*
    Please note that we need two different mobile numbers to process your application to comply with our health and safety policy. Your form will be returned to you if incorrectly completed.

    4. MEDICAL DETAILS

    Please select Yes or No as appropriate and complete further details as necessary.

    Does your swimmer have any specific medical conditions requiring medical treatment and / or medication? YesNo
    If yes, please give details

    Does your swimmer have any allergies? YesNo
    If yes, please give details

    Does your swimmer take any regular medication? YesNo
    If yes, please give details

    Any other relevant information? YesNo
    If yes, please give details

    5. PHOTOGRAPHIC CONSENT

    Guildford City Swimming Club may wish, from time to time, to take photographs, (individual and in groups) of swimmers under the age of 18. All photos will be taken and published in line with Swim England policy. Photographs may be taken to use on the club’s secure website, to include with newspaper articles, to use on club notice boards or for video for training purposes.
    I consent to GCSC taking and using photographs of my child as outlined in Section 5* YesNo

    6. TERMS & CONDITIONS

    Refunds
    Once a clinic has been confirmed then it becomes unavailable to other swimmers. As a result, we do not offer refunds or credits if swimmers cannot attend their clinic, including due to illness or injury. We will endeavour to refill the places your swimmer cannot attend and if successful will credit your Swim Manager account.
    Your signature at the bottom of Section 7 and by submitting this form you confirm that you have read and understood our refund policy.

    Codes of Conduct for Swimmers and Parents
    GCSC requires all swimmers and parents to sign up to our club’s code of conduct and this is extended to our Clinics programme. Attendance on these programmes is conditional upon parents/carers reading and agreeing to Wavepower, Swim England’s Child Safeguarding Policy and Procedures, our Parents’ Training Code of Conduct and Swimmers’ Training Code of Conduct. These can all be found HERE.
    Your signature at the bottom of Section 7 and by submitting this form you confirm that you have read and understood the Wavepower, Swim England’s Child Safeguarding Policy and Procedures, our Parents’ Training Code of Conduct and Swimmers’ Training Code of Conduct.

    Data Protection Act – Privacy Policy
    In compliance with the General Data Protection Regulation 25 May 2018, we will ensure that all information held by the club is accurate, kept up to date and secure and that it is used only in connection with the purpose and activities of the Club. We will hold the data for 3 years after your last contact and then any information will be destroyed.
    The information will be disclosed only to those members of the Club/Swim England for whom it is appropriate and necessary. Swimming England has registered with Data Protection on behalf of member Clubs counties and regions, enabling them to hold personal data of members etc.
    Records are kept on computer / Icloud platforms. Keeping information in this way enables us to run the camps/clinics more efficiently.
    By pressing the ‘submit application’ button you are consenting to Guildford City SC holding your personal data for the purposes of this application as set out above and to give us permission to contact you regarding any future clinics or camps we may run.
    You can request permissions/personal information is deleted before the 3 years by contacting camps.clinics@gcsc.co.uk.

    7. APPLICATION FOR GCSC ACADEMY STARTS/DIVES CLINIC

    All parents must sign and date this section of the form.

    • I have no objection to information regarding me and / or my children being kept on computer.

    • I confirm that all details completed on this form are correct at this time and Guildford City will be made aware immediately of any changes via the email address below.

    • I have read and understood and accept all the Terms & Conditions given in Section 6 of this form.

    • Payment details will follow receipt of the form, subject to a place being available on the clinic. Payment will be collected by Direct Debit and I understand that the swimmer’s place is not confirmed until the confirmed payment is recorded on Swim Manager. After this date the place will be offered to the next swimmer on the waiting list.

                

    Parent’s Name*

    Signature*
    Please type your name where a signature is required.

    Date*

    Prove that you are human*
    Please note that the code may include spaces
    captcha

    PLEASE CLICK THE SUBMIT BUTTON BELOW. A MESSAGE WILL BE DISPLAYED IF THE FORM HAS BEEN SUCCESSFULLY SUBMITTED.
    You will receive a copy of this completed form for your records. Please check your spam folder.