SAIL Program Expression of Interest

Royal Life Saving WA is seeking expressions of interest from families for the Specialised Access and Inclusion Lessons (SAIL) program. Please complete the form below if you are interested in being considered for a 1:1 lesson.

If you are interested in another location to those listed, please enter your preferred location and we will contact you if/when that location becomes available.

Personal Details

Parent/Guardian Name *

Relationship to Student *

Phone *

Email Address *

Postcode *

Student Name *

Student Date of Birth *

Preference Details

Preferred Lesson Day and Time Frame (e.g. Thursdays, Mornings)

Preference 1 *

Preference 2

Preference 3

Preferred Lesson Location *

If other, please specify *

Application Details

Parents/Carers may consider completing this form which is intended to assist your child and their transition into swimming lessons with Royal Life Saving WA. The information you share will be treated as private and confidential. It will only be used to assist the Instructor who will be taking the lessons.

Please specify *

What's the best communication method for the student? *

What's the student's experience in the water? *

Is the student on a behaviour plan that we can support? (e.g. cue words, hand signals, picture schedule) *

Please specify *

Are there any physical limitations the instructor needs to be aware of? *

Please specify *

Are there any specific reinforcements that help the student succeed at home or school? *

Please specify *

What goals do you have for the student in this program? *

Does your child have any defiant behaviours? (e.g. physical or verbal aggression) *

Please specify *

What are some of the student’s interests that we can bring into the class? (e.g. trucks, mermaids, dolphins) *

Are there any sensory issues that are particularly difficult for the student? (e.g. sound, touch, smell) *

Please specify *

Is there any other information not mentioned in the application above that you would like us to know?