Endless Pool Client Information

First name

Last name

Mobile

General Swimming Experience: please tick as many as relevant:

I am comfortable in the water and can swim at least 200m (4 lengths of 25m pool) breaststroke

I am learning to swim front crawl

I am a competent front crawl swimmer, covering 200-400m comfortably

I am a competent front crawl swimmer, working towards longer distances

Tell us a little more about what you'd like to learn in coaching.

Do you have any health problem or injury that may affect your ability to undertake physical exercise in open water?

Yes (please complete next question)

No

Please outline any health issue that may affect your ability to swim or affect your safety during the swim.

Emergency Contact Details

Please give name, relationship and contact telephone number in case of emergency

Name:

Contact Number:

Images

During the session we would like to take videos and photos so that we can analyse your stroke and share that with you. Please tick if you are happy for us to do that?

Are you happy for us to use any images on our social media accounts/website?

Yes

Yes but please share with me first

No