To request a trial at the club, please complete the following form, if you could also add a contact phone number in the swimmers experience box that would be great.

Our Membership Secretary will be in touch to arrange a suitable date for the trial once he receives the completed form. This usually takes place on a Monday evening at Splash Leisure pool.

Once invited to your trial you will be expected to demonstrate backstroke, breaststroke and freestyle. It would be beneficial if you also had experience of butterfly.

We thank you in advance for your interest in the club.

Swimmer Details

First Name

Known As

Last Name

Date of Birth

Our minimum age for new trials is 5

Gender

Select gender Male Female

Swimmer is under 18

Please complete this extra information because the swimmer is under 18 - Phone number and email should also be for Primary Contact

Primary Contact Person

Relationship To Swimmer

Home Phone Number

Mobile Phone Number

Email Address

Retype Email Address

Address Line 1

Address Line 2

Address Line 3

Town/City

County

Postcode

Medical Details

Swimming Experience

Swims For Other Club

ASA Number

Please Select The Disciplines You Are Interested In

Life Saving

Masters

Open Water

Swimming

Synchronised Swimming

Waterpolo

Learn to Swim

Are You Human?

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