Barrow ASC 2021 – Membership Renewel
Application Type

Membership Type

I would like to apply for the following membership
Cost of Membership

Payment *

Member Details

Details must match details currently held and registered on Swim England
Gender *


Current Home Address *

Contact Details

All Members

Swim England Code of Ethics *
Data Consent *
Data Choice


Current Squad
Child Photography Parental / Guardian Consent
Code of conduct for swimmers
Swim Data Choice

Coaches, Teachers and Poolside Helpers

Code of conduct for Coaches, Teachers and Poolside Helpers

Medical Declaration

Do you have any specific medical conditions requiring medical treatment and/or medication *
e.g. epilepsy, asthma, diabetes, allergies, etc.
Do you suffer from asthma *
if you take medication for asthma, (and you are a registered competitor) you are required to complete an ASFGB Medical Declaration Form annually
Do you take medication *
The Equality Act 2010 defines a disabled person as anyone with a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on his or her ability to carry out normal daily activities. Do you consider this child to have an impairment *
It may be essential at some time for the club coach or team manager accompanying your son/daughter to have the necessary authority to obtain any urgent treatment which may be required whilst at a competition with Barrow ASC. I give permission for the Coach / Team manager to give immediate necessary authority on my behalf for any medical or surgical treatment recommended by competent medial authorities, where it would be necessary.


Are you completing this on behalf of your child *
I agree to pay squad fees in full each month, in the event of fees not paid in full the club / committee can seek to recover unpaid fees for a period of up to 5 years.