Entry Form Parent / Carer - information about you First Name Surname Title Relationship to Address Postcode Email Mobile no Text only? Yes No   Tel/Minicom Tel/Minicom no no (day) (eve/weekend) Are you: Deaf Hearing Preferred   language e.g. English/Gaelic/Urdu Information about your child Child’s name Date of birth Male / Female Age (at (please delete as appropriate) time of Swimming club (if applicable) Is your child: Deaf Hearing  impaired Hearing  sibling  How does your child prefer to communicate e.g. BSL, SSE, Speech, Lip Read, etc Does your child have any additional needs, disabilities or medical conditions including allergies in addition to their deafness? Yes No Please give brief details:
Entry Form Parent / Carer - information about you First Name Surname Title Relationship to Address Postcode Email Mobile no Text only? Yes  No  Tel/Minicom no (day) Tel/Minicom no (eve/weekend) Are you: Deaf  Hearing  Preferred language e.g. English/Gaelic/Urdu Information about your child Child’s name Date of birth Male / Female (please delete as appropriate) Age (at time of Swimming club (if applicable) Is your child: Deaf  Hearing impaired  Hearing sibling  How does your child prefer to communicate e.g. BSL, SSE, Speech, Lip Read, etc Does your child have any additional needs, disabilities or medical conditions including allergies in addition to their deafness? Yes No Please give brief details:
NDCS-Gala-Entry-form-and-competition-rules.docx