Bluefins Squad Acceptance/Renewal 2018 /2019 Season

Please complete all fields on this form to accept your squad placement for the new season, starting September 4th 2018. If you have any questions regarding your placement, please contact your current coach in the first instance. One form to be completed per swimmer/player.

If you do not wish to accept your place in the squad, please can you email Thank you.


Swimmer/Player Name:*
Date of Birth:*
Post Code:*
Primary Contact Name:*
Primary Contact Mobile:*
Emergency Contact Name:*
Emergency Contact No:*

Medical Details

The Equality Act 2010 defines a disabled person as anyone with a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on his or her ability to carry out normal daily activities. Please detail below any important medical information that our organisation needs to know. Such as allergies, disabilities & medical conditions. 

Please disclose any medical conditions/medication we need to know about:
Name of Doctors surgery and contact no:*

Parents/carers of members under 18 yrs 

It may be essential at some time for the coach or team manager accompanying your child, to have the necessary authority to obtain any urgent treatment which may be required whilst at a competition or event.   
Do you give permission for the clubs representative on recommendation of competent medical authority, to give the permission for medical or surgical treatment where a delay would be contrary to your child’s interest.

Please select

Registering with Swim England

Further to the Privacy legalisation introduced in May 2018, we require your consent to pass your personal details onto Swim England in order to register with them.  If you select YES, you will receive a link to complete your details direct with Swim England where you have the option to opt in or out of marketing communication. If you select NO, it will mean you will be unable to take part in any swimming competitions. 

Membership Declaration 
1. Declaration:

(a) I declare that all information supplied on the application for membership is true and correct.

(b) I will keep all personal information up to date by immediately notifying in writing of any changes to

(c) I understand that upon payment of my subscription, I will become a member of the club, the region and Swim England and that by paying such fee by the due date, I will remain to be a member of the club, the region and Swim England, until membership is terminated.

2. Club Rules:

As a member I will abide by the constitution, regulations, policies, guidelines, code of conduct, and reasonable directions of the club, the region and Swim England respectively.

3. Club Fees

I agree to pay monthly membership subscriptions by direct debit. I agree for any monies owed in addition to my monthly subscription fee, may be added to my direct debit so long as advance notice has been given to the amount being taken.

4. Termination:

(a) I understand that I may terminate my membership by giving one month’s notice at any time.

(b) I understand that the club, the region or Swim England may terminate my membership with immediate effect in accordance with the provisions relating to this in the Bluefins Constitution and club rules.

5. Your Personal Information:

I agree to my club, the region and Swim England, their employees and affiliates using any personal information provided or otherwise held about me to:

(a) Enable the club, the region and Swim England to have a register of their members as required and any other statute, regulation, by-law or other regulatory instrument that requires collection or disclosure of my personal information; 

(b) Enable my club, region and Swim England to communicate with me and other members about my membership and matters affecting my club, region and Swim England such as their events & activities including communicating with me through newsletters, emails, texts and other electronic messaging and for this purpose to supply information.

(c) Any other purpose I agree to in writing.

I understand that my personal information will only be used for the purposes listed in paragraph 5 and that:

(a) My personal information will be held securely;

(b) I may request a copy my personal information held by the club;

(c) My personal information will be accurate and kept upto date and will be corrected on request; Please refer to our Privacy Notice for further details.

6. Liability:

(a) I will not hold my club, the region and Swim England or their respective officers responsible for any claims, losses and expenses which may arise from or in connection with my membership and/or participation in any activity authorised or recognised by my club, region and Swim England except in the case of gross negligence or a wilful act or omission on the part of my club, region and Swim England.

(b) I indemnify my club, region and Swim England from all claims, losses and expenses suffered or incurred at any time, occurring as a result of or resulting directly or indirectly from my failure to observe the constitution, regulations, policies, guidelines and reasonable directions of my club, region and Swim England respectively.

Code of Conduct Member   Code of Conduct Parents  Constitution   Privacy Notice

I have read and accept the Clubs Code of Conduct:*

Under 18 yrs, parent, guardian, caregiver consent

I am the parent/guardian/caregiver of the applicant who is under 18 years of age. I have read and understood the terms and conditions of membership with Bluefins Swimming Club. I also consent to the use of personal information in accordance with clauses 5 of the membership declaration. 

Parent/Guardian Name:
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What is five plus six?*
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