Trial Request

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Please fill out this form for registering your interest in your child doing a trial for Wisbech Swimming Club. If you have any queries, please contact wisbechsc.clubsecretary@gmail.com .

Swimmer Details

First Name

Known As

Last Name

Date of Birth

Our minimum age for new trials is 5

Gender

Swimmer is under 18

Please complete this extra information because the swimmer is under 18 - Phone number and email should also be for Primary Contact

Primary Contact Person

Relationship To Swimmer

Home Phone Number

Mobile Phone Number

Email Address

Retype Email Address

Address Line 1

Address Line 2

Address Line 3

Town/City

County

Postcode

Medical Details

Swimming Experience

Swims For Other Club

ASA Number

Please Select The Disciplines You Are Interested In

Masters

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