Ngadyung Swim Program
BABIES ENROLMENT FORM
Enrolment Details
Help us serve the community better
Parent/Guardian Name: ___________________________________
Is your child of Aboriginal or Torres Strait Islander descent?
Yes
No
Child 1 Name & DOB :_____________________________________
Child 2 Name &DOB: _____________________________________
Child 3 Name & DOB: ____________________________________
Address: ______________________________________________
Is your child from a non-English speaking background?
Yes
No
How did you find out about Ngadyung Swim Program?
 Friends or Family School  ACT Indigenous Network
Postcode: __________ Contact Ph: _________________________
Email:________________________________________________
Suggested Lesson Level:
(Please refer to level guide and tick)
Wonder 1 Stage 1 or 2:
6 – 12 Months
Wonder 2 Stage 3 or 4:
1 to 2 years
Wonder 3 Stage 5 or 6:
2 to 3 years
Information for our instructors
Does your child have a medical condition/disability that may affect
participation in Ngadyung Swim Lessons (eg. asthma, epilepsy)? Or is your child
currently taking any medication?
Yes 
No 
If yes, give details________________________________________
Has your child had a bad experience in the water?
Yes 
No 
If yes, give details________________________________________
Parent/Guardian Signature________________________
Date _______/________/______________
Indemnity and safety waiver
I agree to my child’s/ward’s attendance at the above mentioned Swim & Survive program. In the case of an emergency, I authorise the program staff, where it is
impracticable to communicate with me, to arrange for my child/ward to receive such medical or surgical treatment as may be deemed necessary. I also undertake to pay
or reimburse costs, which may be incurred for medical attention, ambulance transport and drugs while my child/ward is enrolled with the program.
I understand that although Royal Life Saving and its service providers attempt to minimise any risk of personal injury within practical boundaries, accidents do happen
and all physical activities carry the risk of personal injury. I acknowledge that there is an inherent risk of personal injury in physical activities that will be undertaken as
part of this program and I agree that my child/ward undertakes the activities at his/her own risk.
I release Royal Life Saving and its officers, servants, agents and service providers against all actions, suits, claims, demands, proceedings, losses, damages, compensation,
costs, charges and any expenses whatsoever arising directly or indirectly out of any personal injury to my child/ward howsoever occasioned.
Privacy statement
Royal Life Saving is collecting this information to enable processing of enrolments for Swim & Survive. The information collected will be provided to Swim & Survive
coordinators and class instructors. You are not obliged to provide the information but if it is not provided, Royal Life Saving will be unable to process your enrolment.
Any information provided by you to Royal Life Saving can be accessed by you during standard office hours or updated by writing to Royal Life Saving at [email protected]
or contacting us on 62605800
All information will be stored on a database that will only be accessed by authorised Royal Life Saving personnel and is subject to privacy restrictions.
Please save and send this form to
[email protected]
Or print and post to:
Ngadyung
PO Box 266
Deakin West ACT
2600
Wonder Stages
Water Familiarisation
STAGE 1 – 6 to 12 months
Enter and exit the water safely with carer.
2. Experience the water on the head and body.
3. With instructor guidance and using cue words, undertake
submersion preparation.
4. Display comfort when cradled on the back.
5. Be gently rocked, turned and towed through the water.
6. Be encouraged to splash the arms and kick the legs.
STAGE 2 – 6 to 12 months
1. With support, lean forward, reach for carer's shoulders and enter the
water from a seated position.
2. Exit the water safely with carer.
3. Initiate putting water on the face, head and body.
4. Demonstrate readiness for submersion.
STAGE 5 – 2 to 3 years
With support, enter the water using a slide in entry and hold onto the
pool edge.
2. With minimal assistance, attempt to climb out independently.
3. Blow bubbles in water with the face fully submerged.
4. Demonstrate readiness for submersion.
5. Experience free floating glides for a short distance towards poolside
and hold onto edge with assistance.
6. Float on the back with support under the shoulders.
7. With assistance, rotate body from back to front whilst holding a
flotation aid.
8. Using a flotation aid, demonstrate a kicking action.
9. With instructor guidance, demonstrate pulling arms and hands
through water.
STAGE 6 – 2 to 3 years
5. Experience surface glides with carer using continuous contact.
6. With assistance, float on the back with head on the carer's shoulder.
With support, safely jump into the water from a standing position
towards the carer and return to the wall ready to exit.
7. With assistance, roll from one side to the other - back to front, front
to back.
2. Exit the water safely unassisted.
8. Carer to manipulate legs and arms to kick and paddle on front and
back positions.
3. Blow bubbles with the face fully submerged, take a breath and
repeat the sequence.
STAGE 3 – 1 to 2 years
4. With encouragement, initiate own submersion for short distance and
recover securely.
With support, safely enter the water from a seated position towards the
carer. Be turned towards the edge to hold.
5. With assistance, hold a controlled back float for a period of 5
seconds and recover to a secure position.
2. Hand walk along the pool edge with assistance.
6. With assistance, rotate body in a vertical position whilst holding a
flotation aid.
3. Imitate the blowing of bubbles on the surface of the water.
7. With support, combine leg and arm movements.
4. Demonstrate readiness for submersion.
5. Experience being gently submerged by carer towards themselves.
6. With assistance, float on the back with head on the carer's chest.
7. Experience body rotation in a vertical position.
8. Move legs up and down with carer encouragement. ('kick, kick')
9. Experience reaching for objects and pulling arms through water.
STAGE 4 – 1 to 2 years
With support, safely step into the water from a standing position
towards the carer. Be turned towards the edge to hold.
2. Hand walk along the pool edge and climb out with assistance.
3. Attempt to blow bubbles below the surface of the water.
4. Experience assisted glides from instructor to carer.
5. Experience assisted glides towards poolside and hold onto edge
with support.
6. With encouragement, float on front or back using a flotation mat.
7. With assistance, support self by holding a flotation aid.
8. With support, move the arms and legs through the water.