Supported Lesson Waiting List

  • Supported Lesson Waiting List

  • Date of Birth*
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  • Please fill in the following with as much detail as possible so that we can understand the needs of your child. Once you near the top of the waiting list you will be contacted by email or phone to discuss the options available in more detail.

  • Participant’s Needs

    Please answer yes or no to the following questions about your child/young adult.

  • Are they comfortable in busy environments?*
  • Are they comfortable in social situations?*
  • Are they likely to behave unpredictably?*
  • Are they likely to hurt themselves or others*
  • Do they understand danger, and how to keep themselves safe?*
  • Is your child comfortable with female and male instructors?*
  • Does your child have support at school?*
  • Has your child got any swimming experience?*

  • Medical information

    Please answer yes or no to the following medical questions about your child/young adult

  • Does your child have a disability or additional needs?*
  • Does your child have a diagnosed learning disability?*
  • Do they have epilepsy?*
  • Do they have any other diagnosed medical condition e.g. Asthma, Heart Conditions?*
  • Will access to medication or medical equipment be required during the session?*
  • Can they communicate using spoken language?*
  • Does your child have an EHC plan?*
  • Should be Empty: