ITHACA CREEK SWIMMING CLUB

Established 1968

Phone: 07 3369 6079 Postal Address: Pool Address:

Email: PO Box 673 Dacca Street

Head Coach: Robert Topping – 0432 072 231 Ashgrove Q4060 Red Hill Q4059

Expression of Interest Enrolment Form – Terms 2, 3 and 4, 2015

Swimmer’s Name/s:......

Parent’s Name: ...... (For swimmers under 18 years)

Email: ...... Phone Number:………………………..

Emergency Contact Name………………………………………………………………………Phone Number:………………………..

Please indicate the number of people swimming where relevant:

Easter Intensives / Term 2 / Term 3 / September Intensives / Term 4
Wk One (4 day) / Wk Two (5 day) / Once / Wk / Twice / Wk / Un-limited / Once / Wk / Twice / Wk / Un-limited / Wk One (5 day) / Wk Two (5 day) / Once / Wk / Twice / Wk / Un-limited
Learn to Swim
Stroke
Mini
Junior
Inter-mediate
Fitness

We acknowledge that

1.  The above times are provisional and will depend on enrolment numbers, lessons will be filled from the earliest first. These changes will be advised by the club.

2.  We will be advised if bookings are to be taken once the continuing operation of the Swim Club is confirmed.

3.  Subject to point 2, money will be deducted in week one of the relevant term or one week prior to the start of the intensives.

4.  Should the Swimming Club cease operation then all refunds will be made in full in the second week of the relevant term where money has already been deducted.

Confirmation:

  • Please tick the box to confirm you have read, understood and agree to the following conditions.

(Please contact the club coordinator for clarification if required

Payment by Credit Card: Credit Card Name: ...... Mastercard/Visa only.

Credit Card Number:…………………………………………………………………………Expiry………………………CCV……………..

Parent/Swimmer’s Signature ......

Prices are as follows:

Easter Intensives / Term 2 / Term 3 / September Intensives / Term 4
Wk One (4 day) / Wk Two (5 day) / Once / Wk / Twice / Wk / Un-limited / Once / Wk / Twice / Wk / Un-limited / Wk One (5 day) / Wk Two (5 day) / Once / Wk / Twice / Wk / Un-limited
Learn to Swim / 45 / 55 / 125 / 195 / 230 / 125 / 195 / 230 / 55 / 55 / 125 / 195 / 230
Stroke / 50 / 60 / 125 / 195 / 230 / 125 / 195 / 230 / 60 / 60 / 125 / 195 / 230
Mini / 55 / 65 / 125 / 195 / 230 / 125 / 195 / 230 / 65 / 65 / 125 / 195 / 230
Junior / 60 / 70 / 125 / 195 / 230 / 125 / 195 / 230 / 70 / 70 / 125 / 195 / 230
Inter-mediate / 65 / 75 / 135 / 215 / 245 / 135 / 205 / 245 / 75 / 75 / 135 / 215 / 245
Fitness / N/A / N/A / 140 / 200 / 250 / 140 / 200 / 250 / N/A / N/A / 140 / 200 / 250

Swimming times will be normal programmed times on the following days:

Easter Intensives / Term 2 / Term 3 / September Intensives / Term 4
Daily / Mon / Tue / Wed / Thu / Fri / Mon / Tue / Wed / Thu / Fri / Daily / Mon / Tue / Wed / Thu / Fri
Learn to Swim (PM only) / ü / ü / ü / ü / ü / ü / ü / ü / ü
Stroke (PM only) / ü / ü / ü / ü / ü / ü / ü / ü / ü
Mini AM / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü
Mini PM / ü / ü / ü / ü / ü / ü / ü
Junior AM / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü
Junior PM / ü / ü / ü / ü / ü / ü / ü
Inter-mediate AM / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü
Inter-mediate PM / ü / ü / ü / ü / ü / ü / ü
Fitness (AM only) / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü / ü