ASC Try-Out Request Form

Try-Out Request Form

Thank you for your interest in joining the Australind Swimming Club. We have minimum standards for our squads to ensure that swimmers are able to successfully train with us. We recommend swimmers have passed Stage 8 of the WA Education Department or Royal Lifesaving Society’s Swim and Survive program or equivalent. If your swimmer can meet this standard, or you are not sure, but think that they might be close, please complete this form and we will get back to you as soon as possible with a try-out date. Try-outs are held upon request and will usually last for 15 minutes.

Please enter your swimmers full name *

First

Last

Swimmers date of birth (please input date dd/mm/yyyy) *

Gender

Male
Female
Non-binary
Prefer not to say

Email *

Comment or Message *

Swim certificate level achieved (if applicable)

Emergency contact full name *

Emergency contact phone number *

Previously a member of this or any other swimming club

Details if YES to question above

Were you referred by another ASC member? Please enter their name below

Informed Consent and Acknowledgement *

I, as the Swimmer or Parent/Guardian, (in respect to an applicant under the age of 18 years): 1. understand that Swimming WA and the Australind Swimming Club will be responsible for handling personal information. This is for emergency contacts and medical information and personal information will not be passed on to any other third party without the applicant’s consent. 2. assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Australind Swimming Club and all its respective officers, agents, and representatives from all liability for injuries to said child participating in or conducted during the sessions. 3. consent for my child to be administered such emergency medical treatment as is reasonable/necessary and that I will reimburse any necessary expenses incurred. 4. hereby waive all claims against Australind Swimming Club including all coaches and affiliates, all participants, and, if applicable, owners and lessors of premises used to conduct the event. I have read, understood, and agree to the above declarations.