Swimming Lesson Registration - Mid Devon Leisure

Register for swimming lessons

Centre to contact (required)

Childs Membership (required)

Zest Number(s)

Child's Name (required)

Child's Date of Birth (required)

Parents's Name (required)

Address (including post code) (required)

Email (required)

Phone Number (required)

Secondary Contact (name, relationship to child, contact number) (required)

Details of any medical conditions, i.e. asthma, heart condition etc (if none please use: N/A) (required)

Details of any Allergies or Phobias (if none please use: N/A) (required)

Details of any hearing impairment (if none please use: N/A) (required)

Details of any sight impairment (if none please use: N/A) (required)

Details of any behavioural or learning difficulties (if none please use: N/A) (required)

Please advise if your child has any extra provision/support in school (if none please use: N/A) (required)

Any other information you think we should be aware of (if none please use: N/A) (required)

I/we give consent for my child to be given any emergency treatment deemed necessary by either Mid Devon Leisure qualified first aiders or the emergency services. (required)

All Mid Devon Leisure staff has an enhanced DBS check and undertakes regular safeguarding training.

Further to recent NSPCC advice, we are required to inform you that there are aspects of our teaching/coaching which may require a “hands on” technique.

This type of physical contact between teacher/coach and pupil will only be used in full view of viewing areas and class and will only be used for the following reasons:

Where it is essential to support the pupil during the early stages of learning a skill for safety reasons.
To develop the skills and technique needed (e.g. placing the pupil in the correct position).
To prevent any injury.
To provide additional support as required for pupils with disabilities.
To treat any injury (only relates to staff who are qualified to give first aid).

Please let us know on joining the course/lesson programme if you are uncomfortable or have any concerns with any aspect of this teaching technique.

I/we give consent for my child to receive required physical contact relating to the information above. (required)

I/we give consent to Mid Devon District Council the right to use the photograph(s) resulting from the photo shoot and any reproductions or adaptations of the photograph(s) for any relation to the council’s work including, without limitation, in any of the councils publicity materials such as publications, websites, Facebook, Twitter, Instagram and for supplying to the Media (newspapers, magazines or television) (optional)