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Lane Leader Membership & Registration Form 2024-25

Membership & Registration Form 2024-25

A separate from must be completed for each swimmer or official. When applying for membership for the FIRST time a registration or clearance process must also be followed.
You will receive an e-mail with a link that must be completed via Swimconsult. If you do not receive this link please contact Bianca laneleader@swimconsultsa.co.za to enquire.
Please ensure you add your correct email address to the form submission.

Email *

Swimmer Name & Surname *

TERMS & CONDITIONS

I undertake to participate at own risk for Lane Leader swimming club and will not hold the club or company or its coaches responsible for any loss which may occur as a result of participation in activities of the club. I also understand that I am not able to hold these parties responsible for any costs that may be incurred in relation to Sports injuries. I hereby confirm:

1. That I am aware of, take cognisance and submit myself to the rules and practices pertaining to the Lane Leader Stellenbosch swimming club as well as the facility rules and club constitution and bylaws.

2. I am available to participate, subject to selection at all competitions the club participates in.

3. Swimming/Land training/conditioning fees for Senior, Youth and Junior groups are payable in advance per month for 12 months per year or per semester unless a swimmer discontinues enrolment in a particular group. Should a member wish to discontinue training a notice period of 1 month is required. The full fee is payable irrespective of number of lessons attended.

I agree to all of the above *

SWIMMER or OFFICIAL REGISTRATION:

Swimmers participate in competitions and Officials act as time keepers, judges, starters and general referees

I wish to register with SSA:

(this includes Swimming South Africa, Western Cape Aquatics & Cape Winelands Aquatics): *

SWIMMER INFO:

Swimmer Full name as per ID/Birth Certificate *

Swimmer Gender *

Swimmer Date of Birth - please select *

Swimmer School name, Tertiary Institution, professional athlete, employed *

Swimmer Upload a head and shoulders picture of swimmer

Uploads are stored with your submission when supported.

Swimmer status - please select *

For NEW Swimmers:

Which year & month do you intend to start training with a squad? Please select

For EXISTING Lane Leader swimmers:

Current Group Allocation and season Commitment - please select *

CONTACT & BILLING

Your details - please select *

Correspondence Email address *

Person responsible for payment: full name *

Person responsible for payment: e-mail *

Person responsible for payment: mobile *

FEDERATION REGISTRATION

Registration to swim District (Winelands), Provincial (Western Cape), Regional (Swim SA), National(Swim SA) & International competitions (FINA / WORLD AQUATICS)

I want to register at the following Level - please select: *

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