Medical Information

Daventry Dolphins Swimming Club

Affiliated to East Midlands Region & Northamptonshire ASA


There may be times when a swimmer cannot undertake full training due to ongoing or temporary medical conditions, therefore it is essential that the Club is provided with up to date relevant information regarding the fitness of the participant. (for example: broken arm but the swimmer may be able to have a waterproof cover and do kick sets instead….).

This form allows the participant to give details of what training can or cannot be undertaken. You may be required to provide evidence from a Doctor or other healthcare professional, such as a specific health care plan.

The information provided will be treated in the strictest of confidence:


Swimmer Name/Squad:

Medical condition and a brief description of any limitations this may place on swimmer's ability to train: