Name (Required)
Email (Required)
Gender FemaleMale
Date Of Birth (Required)
Cell Number (Required)
Medical Aid Name
Membership Number
Main Member Full Name
Main Member ID
Swimmer Allergies
Swimmer Injury/Illness
Swimmer Chronic Medication
Relation ---MotherFatherGuardianEmergency Contact (Adult Swimmer)
Name
Cell
Email
Responsibility ---Contact First In EmergencyContact For SchedulingResponsible For Account
I hereby indemnify, hold harmless and absolve from liability AEC Swimming School/Club and all its members, employees and agents from any claim which might arise from an injury sustained or damage suffered by him / her whilst making use of the services provided by AEC Swimming School/Club, it’s members, employees and agents and which is caused by any act or omission of AEC Swimming School/Club. I recognize that injuries can occur in and around the pool. I acknowledge that the enrolled swimmer is fit enough to participate in an exercise programme at AEC Swimming School/Club. I understand that risk and accidental injury is involved in any exercise/swimming activity.
