Lifesaving education program booking form

Lifesaving education program booking form

For all schools and community groups
What type of Lifesaving education program are you booking? (select one or more)*

At the beach, river, lake or pool (metro Melbourne / Geelong)At the beach, river, lake or pool (Regional Victoria)In the classroom (metro Melbourne / Geelong)In the classroom (Regional Victoria)The Bubble- A sensory water safety experience
School/organisation name*
School/organisation name*
School/organisation name not shown?
School/organisation type*
School/organisation type*
School/organisation address*

Street Number/Name

Street Name

CityState

Post Code
Organisational email address
School or organisation email address eg. primary.school@edu.vic.gov.au
Booking contact name*

Your first nameYour last name
Booking contact phone number*

Area codeYour phone number
Booking contact email*
Your email address
Booking contact role/position
If other was listed, please expand:

Lifesaving education program

In the classroom - Melbourne/Geelong
Program location & type
Preferred program location*

My program is being held at the school/organisation address previously listedMy program will be at a location different to the one previously listed
Program Location

Street Number/Name

Street Name

CityState

Post Code
Program date & time
Preferred program date*

DayMonthYear
We will book this date if available
Second preference program date

DayMonthYear
If preferred date not available or booking multiple days
Third preference program date

DayMonthYear
If preferred date not available or booking multiple days
Fourth preference program date

DayMonthYear
If preferred date not available or booking multiple days
Number of sessions requested*
We recommend group sizes no larger than 60 participants. There is no minimum group size.
Preferred session times

9:00am - 10:00am10:00am - 11:00am11:30am - 12:30pm12:30pm - 1:30pm1:30pm - 2:30pm2:30pm - 3:30pmOther session time/s
Is there anything else we need to know?
Please provide any information regarding preferred session times and group sizes for each session or information about the student cohort relevant to program booking.

Lifesaving education program

In the classroom - Regional Victoria
Program location & type
Preferred program location*

My program is being held at the school/organisation address previously listedMy program will be at a location different to the one previously listed
Program Location

Street Number/Name

Street Name

CityState

Post Code
Term 3 2025 dates

Dates

Regions

Venue Schedule

Monday 25 August - Friday 12 September 2025

Alpine, Bass Coast, Bendigo, Campaspe, Colac Otway, Corangamite, East Gippsland, Geelong, Glenelg, Horsham, Latrobe, Mansfield, Mildura, Mitchell, Moira, Moyne, Shepparton, South Gippsland, Surf Coast, Swan Hill, Wangaratta,
Warrnambool, Wellington, Wodonga

Preference will be given to those based in the selected regions. All other requests will be considered.

Please select all available dates. Schedules will be collated in the coming weeks and registered schools contacted.

Program date & time
Preferred program date*

DayMonthYear
We will book this date if available
Second preference program date

DayMonthYear
If preferred date not available or booking multiple days
Third preference program date

DayMonthYear
If preferred date not available or booking multiple days
Fourth preference program date

DayMonthYear
If preferred date not available or booking multiple days
Number of sessions requested*
We recommend group sizes no larger than 60 participants. There is no minimum group size.
Preferred session times

9:00am - 10:00am10:00am - 11:00am11:30am - 12:30pm12:30pm - 1:30pm1:30pm - 2:30pm2:30pm - 3:30pmOther session time/s
Is there anything else we need to know?
Please provide any information regarding preferred session times and group sizes for each session or information about the student cohort relevant to program booking.

The Bubble- A sensory water safety experience
Program location & type
Preferred program location

My program is being held at the school/organisation address previously listedMy program will be at a location different to the one previously listed
Address

Street Address

Street Address Line 2

CityState

Postcode
If known, what gym/hall or outdoor space will be used
Outdoor tent: 3.6m x 5m x 5m, weighted down with 10x 30kgweights (no pegs) Indoor tent: 3m x 6m x 6m, access to power to set-up required. Options to run modified program with specialised equipment if space and weather prohibits tent set-up.
Program style
Choose from our three tailored options—Explore and Play, Guided Discovery, or Total Immersion—to provide an enriching experience that best suits your students' needs.

Explore & Play: 20-minute sessions for students to independently explore and interact with all of the different activities within 'The Bubble.'Guided Discovery: 30–45-minute sessions where students rotate through 3 pre-selected activities, each facilitated by a designated instructor to enhance the learning experience.Total Immersion: A 60-minute session offering a complete experience of 'The Bubble,' including a facilitated education session and time for independent exploration.
Program date
Preferred program date

DayMonthYear
Date
Second preference program date

MonthDayYear
Date
Third preference program date

MonthDayYear
Date
Number of sessions request

Education program terms and conditions

Once you hit submit, you will receive notification that your booking request has been received by LSV. If we have availability for your preferred program dates, we will send a booking notification with a link to sign the terms and conditions (shown below). The terms and conditions need to be signed by an authorised delegate and returned within four weeks to secure your booking and receive confirmation.
How did you hear about this program?*
Should be Empty:

Lifesaving education program booking form

Participant and supervisor details

Lifesaving education program

Program location & type

Program date & time

Lifesaving education program

Program location & type

Program date & time

Lifesaving education program

Program location & type

Program date & time

Lifesaving education program

Program location & type

Term 3 2025 dates

Program date & time

The Bubble- A sensory water safety experience

Program location & type

Program style

Program date

Education program terms and conditions