Clinics Camps Workshops Application

High Performance Clinic/Camp/Workshop Booking Form

Please complete form below. No bookings are confirmed until the completed form and full payment are received. Please complete one form per swimmer and 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.






    I am applying for:-

    Senior ClinicsYesNo

    Junior ClinicsYesNo

    Endurance WorkshopsYesNo

    Summer TickoverYesNo

    1 Camp / Clinic / Workshop

    Stroke: Date: Time: Cost £:

    2 Camp / Clinic / Workshop

    Stroke: Date: Time: Cost £:

    3 Camp / Clinic / Workshop

    Stroke: Date: Time: Cost £:

    4 Camp / Clinic / Workshop

    Stroke: Date: Time: Cost £:

    5 Camp / Clinic / Workshop

    Stroke: Date: Time: Cost £:

    6 Camp / Clinic / Workshop

    Stroke: Date: Time: Cost £:

    Total Cost £ (Required): PLEASE DO NOT MAKE PAYMENT UNTIL REQUESTED

    Please enter the total cost of all camps/clinics/workshops requested.
    Senior Clinics cost £68 each (or £59 each if 6 are booked within one family)
    Junior Clinics cost £38 each (or £32 each if 4 are booked within one family)
    Endurance Workshops cost £59 each (or £50 each if 4 are booked within one family)
    Summer Tickover camps cost £115 for a 10-hour camp and £92 for an 8-hour camp

    Swimmers Details

    Name of Swimmer (required)

    First Name Surname

    Date of Birth (required)

    Please confirm year of birth – format yyyy (required)

    For Endurance Workshops please enter 2 PBs for

    400m: 800m: 1500m:

    Club (required)

    Squad (Guildford City Swimmers only)

    Gender

    MaleFemale

    Number of hours of training swimmer undertakes each week (required)

    To find your ASA number please click the link to the ASA website in the box at the top of the page.

    A.S.A. Number (required)

    Parent / Guardian Details Details

    Must be completed for all swimmers under 18.

    Name

    First Name Surname

    Relationship to swimmer

    Address

    Your Email (required)


    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 of fees

    Home Phone No: Mobile:

    Emergency Phone No (required)


    A further contact number of a person we can contact in an emergency is essential.

    Medical Details

    To be completed by members 18 years or over, or by parent / guardian of swimmers under 18 years old.
    Please select Yes or No as appropriate and complete further details as necessary.

    Do you or you child have any specific medical conditions requiring medical treatment and / or medication?
    YesNo
    If yes, please give details

    Do you or does your child have any allergies?
    YesNo
    If yes, please give details

    Do you or does your child take any regular medication?
    YesNo
    If yes, please give details

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

    Parent’s Photography Consent

    Guildford City Swimming Club may wish to take photographs, (individual and in groups) of swimmers under the age of 18. All photos will be taken and published in line with ASA 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. A professional photographer (suitably approved) may take photos at competitions attended.

    Consent given ?
    YesNo

    Signed Date

    Please type your name where a signature is required.

    Payment

    Payment details will follow receipt of the form, subject to a place being available on the camp / clinic.

    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 gcsc.camps@gmail.com.

    Application for training camp / clinic

    • 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 agree to transfer full payment and understand that the swimmer’s place will not be confirmed until full payment is received. Please note the payment due date on the email. 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

    If you are not a member of Guildford City Swimming Club, please could you tell us how you heard about the swimming camps / clinics run by Guildford City Swimming Club.

    Prove that you are human

    captcha

    PLEASE CLICK THE SUBMIT BUTTON BELOW. A MESSAGE WILL BE DISPLAYED IF THE FORM HAS BEEN SUCCESSFULLY SUBMITTED.