Postal AddressWoodford Swimming PoolInternet

PO Box 159Ph: 07 5496 1918

Caboolture QLD 4510Fax: 075496

ABN:92 967 232 136

Enrolment details:

Start date:
Level: / Seahorse / Swordfish / Stingray / Octopus / Dolphin / Shark
Child name:
Address:
Date of birth:

Parent/guardian details:

Name:
Home number: / Mobile: / Work:

Note: Contact numbers which you provide may be used to update council’s records.

Email:

How did you hear about us: Newspaper School newsletter Letterbox Website Friend

Drive past / Other (please specify :

Emergency contact:

Name: / Relationship:
Daytime contact number:

Medical information:

Does your child have any of the following medical conditions?

Asthma Epilepsy Diabetes Stings Allergies Other:

Details:

Consent:

I, / hereby give consent for my child, / to attend the Learn

to swim program at Woodford Swimming Pool. I hereby authorise the staff at the Woodford Swimming Pool to organise any medical or hospital treatment as they see necessary at my expense.

Parent/guardian:
Signature: / Date:

Privacy statement

Moreton Bay Regional Council is collecting your personal information for the purpose of processing your application to participate in a learn to swim program. The collection of this information is authorised underthe Local Government Act 2009. Your information will not be given to any other person or agency unless you have given us permission or we are required by law.

Learn to swim program levels:

Seahorse / Focuses on water familiarisation and is for children aged 6-36 months with a maximum class size of 8
Swordfish / Focuses on water familiarisation and water safety and is for children aged 3 years with a maximum class size of 4
Stingray / Focuses on body positioning and is designed to help children gain confidence as well as the skills to progress quickly through the next few levels. Maximum class size of 5 children
Octopus / An introduction to freestyle and backstroke and has a maximum class size of 5 children
Dolphins / Focuses on breathing in freestyle and backstroke as well as introductory butterfly. This class has a maximum size of 5 children
Sharks / Introduces bilateral breathing and improves freestyle, backstroke and butterfly techniques, and also introduces breaststroke. This class has a maximum size of 6 children

Terms and conditions:

  • Fees for all lessons to be paid in full upon enrolment – i.e. Full term & pro-rata (i.e. those who join after start of term)
  • Re-enrolment is necessary for each Learn to Swim (LTS) term block. Automatic rollover does not apply.
  • Make-up lessons are only available upon presentation of a medical certificate which must be presented within a week of

the child’s absence from their LTS class. Make-up classes are subject to the respective class available within the term (e.g. stringray);

  • LTS policy is available from reception if required;
  • Moreton Bay Regional Council has a ‘No refund’ policy;
  • No other swimmers are permitted in the pool during Learn to Swim classes (including siblings);
  • Non-LTS children must be paid for if having a recreational swim during or after a sibling’s LTS class.

Office use only
Council officer:______Receipt number:______
Amount: ______Date:______
Cash/Eftpos

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