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MEDICAL INFORMATION

MEDICAL DISCLAIMER OR FULL DISCLOSER OF ANY MEDICAL CONDITION IS MANDATORY FOR EVERY SWIMMER JOINING EITHER THE COMPETITIVE CLUB OR SWIM SCHOOL

IT IS THE RESPONSIBILITY OF THE SWIMMER IF OVER 18 AND THE PARENT OR GUARDIAN OTHERWISE TO KEEP THE CLUB FULLY INFORMED OF ANY MEDICAL CONDITION

PLEASE COPY AND PASTE THIS FORM AND RETURN VIA EMAIL TO :- membershipaquajets@gmail.com

All information is held in the strictest confidence and the coaching/teaching staff are made aware of any medical conditions, so that the best of care can be offered to the swimmer at all times.

 

NAME

DATE OF BIRTH

ADDRESS

TELEPHONE NUMBER

MEDICAL HISTORY

Does  the swimmer have asthma?

If yes please give details of any medication being used

 

Does the swimmer have any allergies?

If yes please give details of anything  the swimmer may have a reaction to and the steps to be taken if this occurs

 

Does the swimmer have an ongoing injury?

If yes please give details

 

Does the swimmers take medication?

If yes please give details

 

Does the swimmer have any medical condition that the coaching staff or club need to be made aware of?

Please give full details along with medical history

 

 

Signed

Dated