Swim School medical credit

Did you or your child miss swimming lessons due to illness?

Read the Terms and Conditions below, then complete the form to request a 50 per cent credit on your membership.

The request for a 50 per cent credit due to missing lessons must be lodged within 30 days since the first lesson was missed.
The minimum period that can be credited is two consecutive weeks. The maximum period is four weeks.
I understand that my membership will be inactive during the credit period.
I understand that any credit granted is applied towards future membership fees.
We will decline your credit request if it does not meet these terms and conditions.
I understand that this is a request only and in no way is an agreement to undertake or accept the request.
A Medical certificate must be supplied as evidence, covering the dates specified in this application.

Parent or guardian details

First name *

Last name *

Preferred phone number *

Email *

Student details

First name *

Last name *

Membership number *

Date of birth *

Medical details

Date of first lesson missed *

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Date of last lesson missed *

Press the down arrow key to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

Why the membership cannot be utilised: *

Attach relevant medical certificate: *

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Agreement

I understand that this is a request only and in no way is an agreement to undertake or accept the request. *

The request for credit due to missing lessons must be lodged within 30 days since the first lesson was missed. *

The minimum period that can be credited is two consecutive weeks. The maximum period is four weeks *

I understand that my membership will be inactive during the credit period. *

I understand that any credit granted is applied towards future membership fees. *

Please confirm you are a person. *

Privacy

The personal information requested is required primarily for the provision of the service referred to on this form and will only be shared with those directly responsible for providing that service. If you do not provide the information, we may not be able to deliver the service. If you would like to know more about privacy at Glen Eira City Council, including your right to seek access to any information collected on this form, please visit our Privacy page or contact Council’s privacy officer on 9524 3333.

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