Aspley Re-Booking Form

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Is this booking for Term 3 or Term 4?*
- Term 3
- Term 4
Parent / Guardian / NOK Name
First Last
Email
Please tick this box if this is a NEW email address for you
- This is a new email address
Phone
Have your address and / or emergency contact details changed?
- Yes
New Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
New Home phone
New Emergency contact person
If a Swimming Club member - which Club?
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If any of the swimmers being booked for Term 2 swam for the whole Term 1 program, please list their names below:
Aspley State School families- if your swimmer/s require collection from Camp Australia please advise. IMPORTANT NOTE: We can only provide support to LTS children who attend Camp Australia on a Tuesday & Wednesday
Any new additional Information that may be important for us to know
How many swimmers would you like to re-book?
Swimmer 1
Please enter the details below for the first swimmer.
Swimmer's name
Does this swimmer have a medical condition?
- No
- Yes
Please advise and include treatment / medication
Is this swimmer in Learn to Swim or Squad?
- Learn to Swim
- Squad
Select your Learn to Swim Class
Which Squad
Please advise Rookie, Intermediate or Advanced
How many sessions per week do you want to book?
Preferred days:*
Please advise in order of preference
Preferred start time - Learn to Swim 3.15pm, 3.45pm or 4.15pm or Sat morning from 8.30am
Please advise in order of preference
What school does this swimmer attend?
Is there any additional information that we need to know about your swimmer or this booking?
Swimmer 2
Please enter the details for the 2nd swimmer below.
Swimmer's Name
2 Does this swimmer have a medical condition?
- No
- Yes
Please advise and include treatment / medication
2 Is this swimmer in Learn to Swim or Squad?
- Learn to Swim
- Squad
Select your Learn to Swim Class
Which Squad
Please advise Rookie, Intermediate or Advanced
How many sessions per week do you want to book?
Preferred days:
Please advise in order of preference
Preferred start time - Learn to Swim 3.15pm, 3.45pm or 4.15pm or Sat morning from 8.30am
Please advise in order of preference
What school does this swimmer attend?
Is there any additional information that we need to know about your swimmer or this booking?
Swimmer 3
Please enter the details for the 3rd swimmer below.
Swimmer's Name
3 Does this swimmer have a medical condition?
- No
- Yes
Please advise and include treatment / medication
3 Is this swimmer in Learn to Swim or Squad?
- Learn to Swim
- Squad
Select your Learn to Swim Class
Which Squad
Please advise Rookie, Intermediate or Advanced
How many sessions per week do you want to book?
Preferred days:
(please advise in order of preference)
Preferred start time - Learn to Swim 3.15pm, 3.45pm or 4.15pm or Sat morning from 8.30am
Please advise in order of preference
What school does this swimmer attend?
Is there any additional information that we need to know about your swimmer or this booking?
Swimmer 4
Please enter the details for the 4th swimmer below.
Swimmer's Name
4 Does this swimmer have a medical condition?
- No
- Yes
Please advise and include treatment / medication
4 Is this swimmer in Learn to Swim or Squad?
- Learn to Swim
- Squad
Select your Learn to Swim Class
Which Squad
Please advise Rookie, Intermediate or Advanced
How many sessions per week do you want to book?
Preferred days:
(please advise in order of preference)
Preferred start time - Learn to Swim 3.15pm, 3.45pm or 4.15pm or Sat morning from 8.30am
Please advise in order of preference
What school does this swimmer attend?
Is there any additional information that we need to know about your swimmer or this booking?
*NOTE - If you have more than 4 swimmers please submit the form then complete and re submit another form for the additional swimmers.
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Please note that all efforts will be made to accommodate your booking request however please understand that this is not always possible. Please see us at the pool if you would like to discuss your options or email aspley@swimsolutions.com.au.
I give Swim Solutions permission to use photos / videos of me and / or my child/ren for advertising and promotional purposes. I acknowledge that permission may be revoked by me, in writing, at any time in the future. Once consent is revoked Swim Solutions will discontinue the use of images however I acknowledge that any existing material cannot be edited or deleted. I further acknowledge that participation is voluntary and that I will not receive financial compensation of any type associated with the taking or publication of these photographs or participation in company marketing materials or other company publications. I acknowledge and agree that publication of said photos confers no rights of ownership or royalties whatsoever. I hereby release Swim Solutions, its contractors, its employees and any third parties involved in the creation or publication of company publications, from liability for any claims by me or any third party in connection with my participation.
I agree to the Swim Solutions photo / video / media statement above.*
- Yes
- No
By submitting this re-book form I acknowledge that I have read and agree to the Swim Solutions Booking Terms & Conditions available to view on our website www.swimsolutions.com.au. I also acknowledge I will adhere to any Government directives due to COVID-19, and I agree to follow the direction of Swim Solutions staff to ensure the safety of our community.
I acknowledge the Swim Solutions policy statement above and agree to the advertised Terms & Conditions.*
- Yes

Swim Solutions are based at Aspley State School and offer swimming, water safety classes and squad & fitness sessions for swimmers of all ages and abilities.

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Aspley
Aspley State School
Cnr Horn Rd & Maundrell Tce, Aspley

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PO Box 176 Aspley Qld 4034
info@swimsolutions.com.au

Aspley Enquiries – 0423 002 800
Janelle – 0419 855 004

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Aspley Re-Booking Form

Swimmer 1

Swimmer 2

Swimmer 3

Swimmer 4

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