Booking Form

1. Streamline Junior Swim Camp Booking Form 29th & 31st October 2013 9.15am-3:00pm Abingdon School Sports Centre, Park Road, Abingdon, Oxon, OX14 4DE Cost - £50 Please send completed forms and cheque made payable to AVSC to: Streamline Swimming 67 St Georges Manor, Littlemore, Oxford. Swimmer’s name:__________________________________________ DOB:__________________ Contact telephone:__________________ Address:_________________________________________________ ________________________________________________________ ________________________________________________________ Current Club:_____________________________________________ Parent/Guardian Name:____________________________________ Email:___________________________________________________ Please enter swimmers personal best times for: 200 free: ____________ 50 free: ____________ 100IM: ____________ Best form stroke: please circle: back, breast, fly 100m______________ Parent’s signature:______________________________________________

2. Streamline Junior Swim Camp Medical Form Please fill out the form below and return it with your registration. • Swimmer’s name__________________________________________ • Age as of 29th October 2013 _____________ • Emergency contact numbers: • Name:________________Phone:____________Relationship:_______________ • Name:________________Phone:____________Relationship:_______________ • Name:________________Phone:____________Relationship:_______________ • Doctors name:_______________________Number:__________________________ • Do you suffer from any chronic or recurrent medical condition? Yes/No • Please describe:_______________________________________________________ • ____________________________________________________________________ • Are you currently taking any medication? Please circle: Yes No • What type and how often_______________________________________________ • ____________________________________________________________________ • Do you suffer from any allergies? Please circle: Yes No • Please describe:_______________________________________________________ • Do you have any dietary restrictions or requirements? Please circle: Yes No • ____________________________________________________________________ • Do you have any current injuries? Please circle: Yes No • Describe injury and treatment:___________________________________________ • ____________________________________________________________________ • Parent/guardian Name:_______________________Date:_____________________ • Parent’s signature:____________________________________________________