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Canadian College ItalyCanada's Top High School in Italy

Swim Skills Questionnaire

Required

CCI's Swim Skills Questionnaire is an important tool to help assess the swimming abilities and experiences of our students.
 
It is crucial that the questionnaire is answered honestly and accurately, so that we can best protect each student's safety when participating in water activities, either at the beach, on boats and when signing up for advanced courses, such as scuba and sailing.
 
Please note that a CCI Swimming Waiver and Consent Form must be completed for each student. It will be sent to you via Docusign link.
 
Students may also be submitted to a swim test before being permitted to participate in certain water activities.
  
Namerequired
First Name
Last Name
I am completing this form for CCI'srequired
Can you swim freestyle/front crawl/breaststroke for at least 50 meters (or the length of an Olympic-sized pool) without stopping?required
Can you tread water for at least 1 minute?required
Can you confidently dive into the deep end of a pool and swim to the other end without touching the bottom or sides of the pool?required
Have you ever taken formal swimming lessons from a certified instructor, such as those offered by the YMCA, the Canadian Red Cross and/or city recreational programs?required
Have you taken any lifeguard or pre-lifeguard courses, such as Bronze Medallion, Bronze Cross or Lifeguard Certification? required
Do you know how to perform CPR (cardiopulmonary resuscitation)?required
Do you know how to perform a basic rescue technique, such as a reaching assist or throwing assist?required
Have you ever participated in a swim meet or competition?required
Have you ever had a near-drowning experience or been in a situation where you needed to be rescued from the water?required
Do you know and understand the basic safety rules of swimming, such as never swimming alone and always obeying lifeguard instructions?required
Do you have any medical conditions or physical limitations that may affect your ability to swim, such as an injury or epilepsy?required
Do you feel comfortable swimming in open water, such as a lake or ocean?required
Would you like to participate in the following activities during your time at CCI (full semester or full year students only). Check all that apply:
I hereby acknowledge that all the information provided in this form is true, accurate, and complete to the best of my knowledge and belief.required
Must contain a date in M/D/YYYY format