Swimmer Information

First name*

Last name*

Email*

Address*

Birthday*

Year

Month

Day

M/F

Child's Diagnosis*

Child's Allergies*

Swim Level

Child's communication styles*

Any behaviours we should be aware of. Hitting, kicking, biting etc

I certify that all information provided is correct and I understand that Just Keep Swimming has the right to cancel participation without refund if any of the above information is not completed accurately

Photography and Media Consent & Release Form

First name (swimmer)

Last name (swimmer)

Email*

Date of birth

Year

Month

Day

I hereby grant Just Keep Swimming and its employees the right to take photographs of the identified registered swimmer. I authorize Just Keep Swimming may use such photographs/media with or without my name and for lawful purpose, including publicity, advertising and web content. I agree that Just Keep Swimming assigns and transferees to copyright, use and publish the same in print and/or electronically.

Parental/Guardian Signature if swimmer is under the age of 18*

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Confirm with your initials*

Health declaration

Please fill out the following form.

First name

Last name

Email*

Date of birth

Year

Month

Day

Have you been hospitalized in the last 12 months?

Yes

Are you suffering from a medical condition, illness or injury?

Yes

If you answered yes to any of the questions above, please supply additional information.

Initials*

I declare that the info I’ve provided is accurate and complete.

Just Keep Swimming Calgary

Photography and Media Consent & Release Form

Health declaration

Want to learn more about Just Keep Swimming?

justkeepswimmingcalgary@gmail.com