Can Swim – Family – Pre Program Form

Congratulations on being selected to participate in our Can Swim – Family swimming and water safety program on Friday 19th January at the Pines 4.30pm-5.30pm.

As a part of the program, we ask each participant to complete the following Pre-Program questions.

This will need to be completed by every family member participating and must be completed prior to the program beginning. This means we require you to ask these questions of each child participating separately and of course all adults participating in the program.

Data collection is a vital part of our program planning to assist and inform us in future programming. Data provided in surveys is invaluable.

Can Swim: Family - Pre Program Questions

Participant Name(Required)
Participant Date of Birth(Required)
Have you ever had regular weekly swimming lessons?(Required)

Do you regularly use a backyard swimming pool?(Required)
Do you regularly go to one or more of the following:(Required)
Who do you normally go swimming with?(Required)
Do you know how to perform CPR?(Required)

Do you know how to put on a lifejacket?(Required)