Form Reference C3.3.1 /

Club Membership Form

1st March 2012 – 28th February 2013
This includes registration with British Swimming /

Fields marked * are mandatory. Please complete form using BLOCK letters.

Club Name:*
Forename* / Surname* / Title*
DoB* (dd/mm/yyyy) / Gender* / Male / Female
Postcode* / House No*
Address*
Email*
Tel* Home / Mobile
Work

* See reverse of form for Membership Category (please TICK one category)

SWIMMER / £ 33.00 / NON SWIMMER
·  Club Volunteer
·  Technical Official
·  Teacher & Coach / £10.00

Priority Discipline* Additional Discipline*

Swimming / Masters / Synchro / Swimming / Masters / Synchro
Diving / Water Polo / Open Water / Diving / Water Polo / Open Water

See reverse of form for definition of ‘Priority’ Discipline and ‘Additional’ Discipline selection

Disability / Classification if known / Swimming (S) / Breaststroke (SB) / Medley (SM)

If classification is not known, then please tick nature(s) of disability

Ambulant / Wheelchair / Visual / Hearing / Learning
Country of International Representation* / NB Home Country, Not Great Britain

Eligibility for Scottish Qualification (Please tick one appropriate box)

1. I am a native of Scotland, born in Scotland
2. I am born of a Scottish parent who was born in Scotland
3. I have the residential qualification in accordance with Company Rule R.4.5.3.(c)
Ethnicity / Asian – Indian / Asian – Other / Asian - Pakistani
Black – African / Black – Caribbean / Black – Other / Chinese
Mixed – White/Asian / Mixed – White/Black Caribbean / Mixed – Other / Asian – Bangladeshi
White – British / White – Irish / White – Other / Other Ethnic


Consent

I confirm that I am a member of the club listed above. I agree to abide by the rules of Scottish Swimming. I understand that by submitting this form, I am consenting to receiving information about the Scottish Swimming and British Swimming initiatives and their commercial partners by post, email, online or telephone unless I tell you otherwise.

Offers and opportunities – please tick any of the relevant boxes below to Opt Out

1. / NO, I do not want Scottish Swimming /British Swimming to send me details of products and services or details from
Scottish Swimming/British Swimming commercial partners.
2. / NO, I do not want the Scottish Swimming/British Swimming to send me details of swimming Events.
3 / NO, I do not want to receive an electronic copy of the Scottish Swimming SplashNews Newsletter.
4 / Publication on British Swimming website(s) – please see reverse of form
* Declaration:
Age 16 years or over
I declare that the details above are correct and I confirm that I will submit myself to official Doping Control at any time when required.
(See reverse of form for details on Doping Control). /
Signature
Date
Under 16 years of age
As the parent or person in loco-parentis of the swimmer named in this form, I certify that the personal details are correct. I agree to him/her, if selected, submitting to official Doping Control when requested.
(See reverse of form for details on Doping Control). /
Signature
Date
New members details to be submitted to Scottish Swimming within 28 days of individuals
joining your club in accordance with SASA C3.3.6

Disclosure of your information

Publication on British Swimming website(s). Details of your achievements in events will be included on the British Swimming website(s) and these will be available to the general public. If you do not want your details to be visible in this way you can hide them by registering via the ‘Home Country Membership Check’ accessed through www.scottishswimming.com webpage and selecting the ‘hide’ option, or by contacting the ASA Rankings department with your request to hide your details.

Caution – Publication on British Swimming website(s) If you hide your details they will not be visible on the Rankings Database which may affect your ability to enter events. Event organisers may in these cases require proof of age and/or of eligibility to enter and you should contact the particular organiser to check.
If you do not want details of your achievements to be visible on the British Swimming Website, please tick here

SASA Club Membership Categories

C3.3.3 There is two categories of members of Affiliated Clubs and a member may register in only one category. Those members who fall into
both categories must register as a swimmer and pay the higher fee.
(a)  Swimmer – a member of any age who participates in any aquatic discipline.
(b)  Non-Swimmer – a member who does not participate in any aquatic discipline as defined by the following classifications:
i)  Club Volunteer – a member 14 years and over and not a competitor, who volunteers for their club in any capacity at any time.
ii)  Technical Official – a member who volunteers for their club and who holds a current technical official qualification issued by
recognised governing body for aquatics i.e. British Swimming or international equivalent.
iii)  Teacher and Coach – a member who holds a current teaching or coaching qualification issued by a recognised governing body
for aquatics i.e. SASA, ASA, WASA, British Swimming, an international equavalent, or S/NVQ in coaching.
Medical Declaration form: This information applies if you are a swimmer: 10 years old or older, and Representing Great Britain or their Home Country internationally or competing in a British Swimming, Scottish Swimming, ASA or WASA National event (all disciplines, excluding Masters)
New members details to be submitted to Scottish Swimming within 28 days of individuals
joining your club in accordance with SASA C3.3.6

DATA PROTECTION NOTICE

Collection and use of your information

About us. The Scottish Amateur Swimming Association (SASA) is a constituent member of British Swimming Limited
(British Swimming). The other members are the Amateur Swimming Association (ASA), and the Welsh Amateur Swimming Association (WASA). Purposes. Scottish Swimming and British Swimming will each hold the details provided on this registration form with other information it holds or obtains from or about you and will use this for the following purposes:

·  for maintaining records

·  to respond to any enquiries you make

·  to administer any events in which you participate or may wish to participate and to deal with any incidents involving you

·  to create an individual profile for you so that we can understand and respect your preferences

·  to create anonymised aggregated information about members and swimmers to enable us to secure funding

·  to contact you about swimming events, offers and opportunities available from the Scottish Swimming or British Swimming
or any commercial partner of either of them by post, email, online or phone (where you have indicated you are happy to hear about these)

Recording images. Scottish Swimming and British Swimming may record the competition events in which you participate and general images of swimmers will form part of the information we hold and use. In addition to the purposes for general information set out above, Scottish Swimming and/or British Swimming may use these recordings and images for the purposes of education and training, swimmer analysis, promotion, performance, development and selection and event analysis.

Other uses. Where your information may be used for additional purposes, such as medical information, you will be provided with further details of how your information will be used at the relevant time

Disclosure of your information

Districts and Clubs that organise their own competitions may publish details on this website and if you wish to hide this information you should contact the Region/ County/Club directly.

Data use outside of the EU. If you apply for or take part in an event that takes place outside the European Union, your information will be disclosed to the relevant event organiser(s) in the host nation. These nations may not have laws as stringent as ours to protect your personal data.

Images. Images may be disclosed to those Districts and Clubs for which you are a member for swimmer selection purposes. They may also be disclosed to the media for promoting swimming and the reporting of events. You should see the data protection policy for the relevant Region, Sub-Region, County Association and Club(s) for details of how your information will be used.

ASA and WASA. As constituent members of British Swimming, WASA and ASA will be able to view your information for swimming administration purposes only.

Doping Control. If you enter National or International swimming competitions, you may be subject to doping control as part of the Scottish Swimming/British Swimming commitment to a drug free sport. At the time of sample collection, your personal data will be collected by UK Sport which undertakes the testing and administers the programme. You should see the data protection notice for
UK Sport for details of how your information will be used (http://www.uksport.gov.uk/pages/adams/)

Marketing

Partners. Scottish Swimming and British Swimming each work with a number of sponsors and commercial partners (details of these can be found at www.scottishswimming.com) to promote swimming, raise funding for the sport and to secure opportunities for members. Scottish Swimming and British Swimming would like to contact you by post or electronically to tell you more about the offers available to you. Please help us serve you better by telling us if you express an interest in our goods and services.

Opt outs. You have the right to refuse direct marketing and can do so by ticking the relevant box(es) on the form.