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Halliwick AST
Overseas Club Affiliation Form

Name of Club, School or Establishment:

We the undersigned, on behalf of the above Club, School or Establishment apply for membership of the Halliwick AST and agree to embrace its aims and objectives.
Date:
Chairperson or Headteacher
Name:
Address:
 
Postcode:
Tel:
email:
Signature:
Secretary or Honorary Secretary
Name:
Address:
 
Postcode:
Tel:
email:
Signature:
Club Information
Swim Venue:
Day and time:
No of swimmers:
No of other members:
(helpers, instructors)
Total membership:
Date Halliwick AST Insurance paid:
Extent to which the Halliwick Concept is used: Always | partially | never


Affiliation fee:

Clubs, Schools and Establishments should send this form and a cheque for £25.00 made payable to Halliwick AST, direct to the Association at the ADKC Centre address below:

Halliwick Association of Swimming Therapy
c/o ADKC Centre
Whitstable House
Silchester Road
London W10 6SB
Halliwick AST is a member of the International Swimming Association (IHA) which provides information and support to countries interested in Halliwick and promoting its work.  You may be eligible to join the IHA and information on the IHA can be found at www.halliwick.org