Medical Consent form

Medical Consent Form

  • Please complete one form for each person swimming with the Ballarat Swimming Club. Information provided will only be used in the event your child should need treatment and would be passed onto Medical Personnel by Coaches.
  • DD slash MM slash YYYY
  • Please include family number on card. For e.g 123456789/1
  • 00/0000
  • including asthma, diabetes, epilepsy
  • Name of parent/Guardian completing the Medical consent Form
  • DD slash MM slash YYYY