School Swimming Assessment Form Help us give your child the best experience Parents Name * First Name Last Name Email * Phone * (###) ### #### Childs Name * First Name Last Name Age * School * Year or Grade * Please tick the box that best describes your child's swimming ability * Level 1 - I am a complete beginner Level 1 - I am learning to submerge, blow bubbles and open eyes Level 2 - I can submerge, blow bubbles and open eyes Level 2 - I am learning to swim 5M unassisted Level 3 - I can swim 5M unassisted Level 3 - I am learning to swim 8M freestyle with a board Level 4 - I can swim 8M freestyle with a board Level 4 - I am learning to swim 16M freestyle with a board Level 4 - I am learning to swim 16M backstroke with a board Level 5 - I can swim 16M freestyle and 16M backstroke with a board Level 5 - I am learning to swim 25M freestyle and 25M backstroke Level 5 - I am learning to swim 16M breaststroke kick on back Level 6 - I am learning to swim 25M bent arm freestyle Level 6 - I am learning to swim 25M backstroke with good technique Level 6 - I am learning to swim 16M breaststroke kick on front Level 7 - I am learning to swim 50M bent arm freestyle with bilateral breathing Level 7 - I am learning to swim 50M backstroke with perfect technique Level 7 - I am learning to swim 16M breaststroke (correct breaststroke kick) Level 8 - I can swim 50M bent arm freestyle in under 1:30 Level 8 - I can swim 50M backstroke in under 1:40 Level 8 - I can swim 50M breaststroke 2:00 Level 8 - I am learning to swim 25M butterfly with fins Thank you!
