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A young boy swimming wearing goggles smiling at the camera from the swimming pool

Join our Programme

Once we receive the form below, a member of the Swimming Buddies team will be in touch when a space becomes available with a coach that will be carefully matched to your child's needs.

We appreciate your patience and thanks for getting in touch!

Parent Full Name

Child's DOB

Dr Name

Emergency Contact Name

Child Full Name

Phone

Dr Phone

Address

Dr Address

Emergency Contact

List your child’s official diagnoses (if applicable) and provide details on if your child is Hyper/Hypoactive

My child would accept being helped to learn swimming moves via demonstration

Yes

My child learns well in small groups

Yes

My child take feedback negatively

Yes

My child experiences difficulty with transitions between

People

Places

Activities

Objects

An object/or visual aids would help my child to learn

Yes

My child would feel timers would be helpful

Yes

My child is fully toilet trained

Yes

Is your child happy to have assistance within their personal space

Yes

Loud noises bother my child

Yes

Visual distractions bother my child

Yes

Is your child aggressive - please provide details if applicable

Is your child verbal/non-verbal - please expand if required

Does your child have any other medical conditions or allergies that we should be aware of

These items are helpful in encouraging participation and attention in my child

These behaviours indicate stress in my child

What swimming experience does your child have

How many seconds would your child need to process direction before moving to the next?

Please tell us some fun information about your child

I give permission to coaches to have close contact and if required, actual contact in the pool

I agree to Swimming Buddies contacting me occasionally by post or phone and more regularly by text or e-mail

Thanks for submitting!

Want to join Swimming Buddies?

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Tel: 07746724160

Email: info@swimmingbuddies.co.uk

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