Customer Name *

First Name

Last Name

Phone *

(###)

###

####

Swimmer Name *

First Name

Last Name

Swimmer's Gender *

Female

Male

Swimmers aged 10 years old and under on date of gala (i.e 7, 8, 9 and 10 years) please select which events you would like to enter *

Events are 25m (1 length)

25m Frontcrawl (Freestyle)

25m Backstroke

25m Breaststroke

25m Butterfly

Not Applicable - Swimmer is 11 years plus

Swimmers aged 11 years old and over on date of gala (i.e. 11, 12, 13 and 14 years) please select which events you would like to enter. *

Events are 50m (2 lengths) for Frontcrawl and Backstroke and 25m (1 length) for Butterfly and Breaststroke.

50m Frontcrawl (Freestyle)

50m Backstroke

25m Breaststroke

25m Butterfly

Not Applicable - Swimmer is 10 years and under

I agree to pay the Supervisor in cash on the day of the Gala and understand this money will be donated entirely to charity and is therefore non-refundable *

I agree

Water Creations Swim Academy - Photographic/Film/Video Consent *

In accordance with Swim England Photography Guidance: www.swimming.org/swimengland/wavepower-child-safeguarding-for-clubs/ As the parent/guardian please select the appropriate box/es.

I consent to my child’s photograph/film/video to be used on Water Creations Swim Academy website

I consent to my child’s photograph/film/video to be used within other printed publications such as newspaper articles about Water Creations Swim Academy website

I consent to my child’s photograph/film/video to be used on Water Creations Swim Academy's social media platform/s

I consent to my child’s photograph/film/video to be taken by a professional photographer employed by Water Creations Swim Academy website. *as the official photographer at competitions, galas and other organisational events

I consent to my child filmed by Water Creations Swim Academy for training purposes

I do not consent for my child to be photographed/filmed for any of the above purposes