Waiver Form

By submitting this form, you agree to our Terms and Conditions & Cancellation Policy, as stated on our website - www.togetherweswim.co.uk.

First name(Required)

Last name(Required)

Email(Required)

Phone

Birthday(Required)

Day

Month

Year

Address(Required)

Emergency Contact Name (Required)

Emergency Contact Number(Required)

Do you have any medical conditions? Please answer N/A if none(Required)

Medicine Carried? Please answer N/A if none(Required)

Do you consider yourself to have a disability? If yes, please provide brief details (Required)

Do you have any access needs? If yes, please provide brief details below(Required)

Yes

If you answered 'Yes' to having access needs

Do you use any of the following? (Required)

Glasses

Contact Lenses

Hearing Aids

Prothesis

None of the above

Can you swim 200m comfortably in a pool? (Required)

Yes

Have you been swimming outside before?(Required)

Yes

Can you briefly describe your swimming experience, both indoors and outdoors(Required)

Photos: I am happy for you to take photos of me and / or my swim session and use these for marketing purposes  (Required)

Yes

Data: I will keep your data safe and secure and will not share your data with third parties. Please confirm that you understand this privacy policy. Further information and privacy policy is available on the website . (Required)

Yes

I have answered all the questions above to the best of my knowledge without omitting any information that may affect my ability to swim in cold water. (Required)

Yes

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