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Isabella School Swimming 2023 @ Swim Skills - for life

We are proud to host the Isabella State School Students
for their 2023 swim safety programme! 😊💦

Our swim school prides itself on giving our students life long positive memories of our swim school, and Swim Skills - for life!

Please complete the following swimming assessment form
for your child's 2023 swim safety programme at Swim Skills.

* Indicates required field

Child 1 name *

First

Last

[object Object]

Prep Class *

Prep A Prep B Prep C

Year 1 *

1A 1B 1C 1D

Year 2 *

2A 2B 2C 2D

Year 3 *

3A 3B 3C 3D

Swimming assessment - Please choose 1 box which best describes your child *

Hesitant to enter water Happy in the water but will not submerge Submerges independently but will not move point a to b Can submerge & propel but cannot lift for a breath independently Can propel and lift for 1 strong breath but begins to fail after multiple breath attempts Can propel independently & take multiple breaths independently Propels with freestyle but is inefficient with side breathing Efficient freestyle and side breathing, beginner backstroke Efficient bilateral freestyle and beginner backstroke/breaststroke/butterfly Squad swimmer, efficient in all 4 strokes

Parent/Emergency Contact *

First

Last

Emergency Contact Ph *

Medical Information (This information can protect your child)
Medical conditions:
*if you answered 'Yes' to any of the below, please add more detail below

Ear Disorder/Infections *

Yes No

Breathing Disorder/Asthma *

Yes No

Allergies *

Yes No

Epilepsy/Fainting/Dizzy Spells *

Yes No

Other relevant medical information *

I give my consent for him/her to participate in the swimming program.
I submit the above medical information about my child and include other relevant information and details of limitations which he/she has for the activity concerned.

As Parent/Carer, I give consent by ticking the below box *

Yes No

Comment - Anything else we need to know? *

Email - Please provide your email address if you would like to receive promotional material and special offers for Isabella students! *

Please provide your email address if you would like to receive promotional material and special offers for Isabella students!

Submit

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Isabella School Swimming 2023 @ Swim Skills - for life

We are proud to host the Isabella State School Students ​for their 2023 swim safety programme! 😊💦

Please complete the following swimming assessment form ​for your child's 2023 swim safety programme at Swim Skills.

We are proud to host the Isabella State School Students
for their 2023 swim safety programme! 😊💦

Please complete the following swimming assessment form
for your child's 2023 swim safety programme at Swim Skills.