Swim Sessions Participant Form – Triathlon and Certified Ironman Coaching Newcastle and Northumberland

Please only complete this form having been asked by DS Coaching to do so.

If you have a general enquiry, please visit our get in touch page.

First Name *
Surname *
Gender
Date of Birth *
1st line of address *
Town/City *
Postcode *
Contact Phone Number *
Email *
Are you happy for us to use your email address to send you information about future sessions? *
YesNo

Please provide details of any medical conditions or current medications that we or anyone providing medical care needs to be aware of
Please provide details of any special needs or conditions that we should be aware of and what support/modifications are needed
Do you consent to receive medical treatment if necessary? *
YesNo

Do you give your permission to be photographed or filmed for use specifically for DS Coaching promotion and advertising? *
YesNo

Previous experience
Current ability
Why are you attending sessions? What would you like to achieve?
Please detail any other specific information that is relevant to your participation in sessions with us

Consent and agreement
I have read the information on this form. I understand and agree that I participate in sessions under the instruction of Swim England Teachers / British Triathlon Coaches entirely at my own risk. I have considered the nature of such sessions and I am satisfied that I am sufficiently responsible and competent to assume full and entire responsibility for my own safety under the supervision of the teacher / coach. I am aware that I must abide by the instructions of the teacher / coach or centre staff. I will carry out the session with care and abide by the rules of the teacher / coach and the centre. I agree to DS Coaching's cancellation policy which is available for me to view at https://www.dscoaching.co.uk/cancellation-policy/Agree
Electronic Signature *Please type your name in the box above