Cott Surf Club Swim Registration

COTTESLOE SLSC REGISTRATION
Swimmers Name *
Email Address *
Contact Number *
Do you have Whatsapp for this number? Only used for notifications, ie inclement weather *

Yes No
Parent(s)/Guardian Name if applicable *
Swimmer's Gender *

Male Female
Date of Birth *

Day Month Year Date Picker Icon
Age Group *

Nipper (10/13) U/14 and U/15 U/17 Senior
Are there any Medical conditions we need to be aware of?
What is your consistent time for 100m Freestyle
seconds
We occasionally take pictures of the swimmers in action swimming or doing other activities for our Facebook Page.

We hope to use these to keep the community up to date on the happenings at Cottesloe Surf Club.
Please Click yes if you give permission to have photographs taken *

Yes No
Thank You!
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

COTTESLOE SLSC REGISTRATION