AQUA TOTS BOOKING FORM

Please read the Terms and Conditions and Code of Conduct prior to completing your booking documentation and ensure that you have completed your details in full, including: child's name and date of birth, each time you book an Aqua Tots course.

BABIES MUST BE AGED 1O WEEKS & 10 lbs (4.5 kg) IN WEIGHT & UNDER 18 MONTHS TO START THE AQUA TOTS COURSE
Child's name  Child's Surname  Child's D.O.B 
Your name     
Have your contact details changed?   no  yes
Telephone no.     
Mobile no.  
The onus will be on you to access your answer phone or message service(s) on a regular basis.
Next of Kin  
Next of Kin Tel 
Address 1
Address 2
Address 3
Post Code  
E.mail  e.mail Policy
Do you have high speed internet access (Broadband , ADSL , ... )   no   yes

NEW SWIMMERS (joining Aqua Tots for the first time)

Previous baby swimming club
(if applicable):
How did you hear about us ?
I was recommended by an
Aqua Tots friend, who's name is:
who's baby's name is:

Aqua Tots course fee: £112.50 per term for all pools. Cheque made payable to Aqua Tots
Photo- Membership: £23  Cheque for Membership & merchandise made payable to Aqua Tots.
For merchandise purchased at the pool-site, cheques made payable to your Instructor.


Which term do you wish to enrol on to?
Pool Site Requested
Day
Time

Level 1
Ducklings
Level 2
Cygnets
Level 3
Swans
Level 4
Penguins
Level 5
Beavers
Level 6
Otters
Level 7
Turtles
Level 8
Crocrodiles
Level 9
Seals
Level 10
Dolphins
Level 11
Whales
Level 12
Octopus
Level 13
Rays
Level 14
Mantas
Level 15
Barracudas
Level 16
Sword fish
Level 17
Flying fish
Level 18
Marlins
Level 19
Sharks
Level 20
Tigers
Level 21
Hammerhead
            
Please complete and sign the Parental/Guardian Assumption of Risk Agreement and Booking Form & return with your payment to Aqua Tots, 23A Brighton Road, South Croydon, Surrey, CR2 6EA to be received within the 7 day deadline.

I have read and agree to abide by the
   Terms and Conditions,
   Assumption of Risk Agreement,
   Code of Conduct.

Your signature

Aqua Tots is unable to enter into a binding agreement with persons under the age of 18.
Date
OFFICE USE ONLY
Amount Received.........................
Date Received..............................
 

PARENTAL/GUARDIAN ASSUMPTION OF RISK AGREEMENT

It is important that you read the contents of this agreement before completing and signing as failure to do so will mean that we will be unable to process your booking or allow attendance or participation at Aqua Tots swimming session(s).

This is a statement in which you are informed of the risks involved with swimming and sets out the circumstances under which you, your Spouse/Partner, your child, child's legal guardian or appointed representative(s) which, from here on in known as, for the purposes of this document as those ‘in whose care you have placed your child to attend Aqua Tots, will participate in and which is undertaken at your and their own risk.

Your signature and where applicable, that of your Spouse/Partner, and or those in whose care you have placed your child, to attend Aqua Tots swimming session(s) must be placed on this statement and is required before participating in or attending any Aqua Tots session(s).

Your signature and where applicable, that of your Spouse/Partner, and or those in whose care you have placed your child attend Aqua Tots swimming session(s) is also required on this statement if prior to booking an Aqua Tots course you or they attended any of the venues used by Aqua Tots for the purpose of observing an Aqua Tots swimming session(s).

WARNING
Swimming, as with any activity, which takes place in, on or around any body of water or in the immediate area of any body of water has obvious inherent risks including, but not limited to drowning. When attending any property for the purpose of taking part in or viewing an Aqua Tots swimming session(s) you must ensure that you, those in your care, and those who accompany you, voluntarily or otherwise, follow the Aqua Tots Code of Conduct.

HEALTH
You must advise truthfully and fully inform Aqua Tots and your instructor(s) of any pre-existing medical condition that you or the child and where applicable, that of your Spouse/Partner, or those in whose care you have placed your child may have prior to the start of the Aqua Tots swimming sessions.

You must also inform Aqua Tots and your instructor(s) of any medical condition diagnosed following the start of the booked swimming session(s) for your child and where applicable, that of your Spouse/Partner, or those in whose care you have placed your child for the purposes of swimming with Aqua Tots.

If you have any queries in regard to health issues and swimming, it is advised that you contact your General Practitioner, Health Visitor, and or Paediatrician prior to the signing of this statement and participation in any Aqua Tots swimming session(s).

EXCLUSIONS
Neither Aqua Tots, its employees or the instructor(s) accept any responsibility for any death, injury or loss suffered nor damage to any part of the swimming pool or building in which the pool is located, or any adjoining lands, buildings or boundaries caused by you, your Spouse/Partner, your child, or those in whose care you have placed your child, for the purposes of swimming with or observing Aqua Tots resulting from any conduct, matter or condition under your or their control, which amounts to contributory negligence whilst attending any Aqua Tots swimming session(s).

Neither Aqua Tots, nor its employees or instructor(s) accept any responsibility for any damage, discolouration or tarnishing to any items of jewellery, including watches, worn by you, your child or those in whose care you have placed your child, for the purposes of observing or swimming with Aqua Tots.

Neither Aqua Tots, its employees or instructor(s) accept responsibility for any discolouration to any item of clothing or costume worn for the purposes of swimming by you, your child or by those in whose care you have placed your child purposes of observing or swimming with Aqua Tots.

In the absence of any proven negligence, lack of due diligence or breach of duty by the instructor(s), Aqua Tots, or its' employees, the participation of you, your Spouse/Partner, child, or those in whose care you have placed your child for the purposes of attending or observing Aqua Tots swimming sessions is done so entirely at your and their own risk.

This Assumption of Risk  also extends to any other person(s) who may voluntarily or otherwise, accompany you, your child, your Spouse/Partner, or those in whose care you have placed your child for the purposes of observing or swimming with Aqua Tots.

I acknowledge receipt of this document and have read all the terms before completing and signing this agreemen. I also affirm that I am over 18 years of age.   Aqua Tots is unable to enter into a binding agreement with persons under the age of 18.

Parent/Guardian / Appointed Representative (Print)
  Term
 
Baby's Name (Print)
Pool site
 
Parent/Guardian /Appointed Representative Signature
Date
Day
Time
 
 

COURSE EVALUATION SURVEY

Please can we ask you to take one minute to complete the evaluation survey. Your feedback as a valued customer is important to us. We ask you to grade our performance on the current term from 1- 5: 1 being very poor, 3 acceptable and 5 demonstrating excellence. All answers will be treated confidentially.

Your Present Pool Site
Day
Time
Course Level
Your Instructors Name
Are you likely to rebook for the next term?

Your Instructor
1 2 3 4 5   1 2 3 4 5
Teaching Ability   Safety in water
Skill Demonstration   Friendliness
Voice Communication   Appearance
Inform you of Aqua Tots news
(term dates, photos, booking procedures etc.)
  Inform you of Aqua Tots range of Products

Aqua Tots Swim Program
1 2 3 4 5   1 2 3 4 5
General quality   Beneficial for your baby
New Skills introduced this term in
your recent level
  Your baby's Water Confidence,
is baby happy at lessons
Suitability to your baby's age / ability   Parents confidence in handling
your baby in water
Health & Safety   Fun

Customer Service
 
Administration
1 2 3 4 5   1 2 3 4 5
Response time to queries   Newsletter
Telephone manner   Swim Guides
Friendliness   Office hours
Efficiency in dealing
with your queries
  Re-booking procedures /
New Terms and Conditions

Pool Facilities
1 2 3 4 5   1 2 3 4 5
Changing area   Pool water Quality
General cleanliness   Pool water Temperature
Health & Safety   Parking availability

 

IMPORTANT NOTICE

Please do not write any comments on the evaluation form. the information is not colated by Aqua Tots, but by an external body, who only use the information provided in this form. If you have any comments or suggestions, please, as advised in our Terms and Conditions, either e-mail or write to the addresses given on the Terms and Conditions, so that we may, where requested or required provide a written reply. Thank you very much for your time.

 

 



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