SRC Course Registration Form 2025
Please fill out the form slowly and carefully to ensure all your details are correct. Due to training capabilities, the SRC course will be capped at 48 spots.
Section 1 | Candidate Details
Candidate Name
*
First Name
Last Name
Candidate Gender
*
Male
Female
Non Binary
Prefer not to disclose
Other
DOB *candidate must be at least 13 years of age by assessment date (30/12/24)* Unfortunately there will be no exceptions to this rule.
*
-
Day
-
Month
Year
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Candidate Email
Please detail any relevant medical history, injuries, allergies, learning needs or mental health problems we need to be aware of:
*
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Section 2 | Parent/Emergency Contact Details
Parent/Emergency Contact Name
*
First Name
Last Name
Preferred Mobile Number
*
Please enter a valid phone number.
Preferred Email Address
*
*A copy of this form will be sent to this email address
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Section 3 | Uniform Sizes
* Please note that uniforms are in ADULT size**
Male Patrol Shirt Size
*
XS
S
M
L
XL
Not Applicable
Male Patrol Short Size
*
26
28
30
32
34
36
Not Applicable
Female Patrol Shirt Size
*
6
8
10
12
14
16
Not Applicable
Female Patrol Short Size
*
6
8
10
12
14
16
Not Applicable
Unisex Long Sleeve SRC Top
*
XS
S
M
L
XL
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Section 4: Social Media Consent
Photos from this course may be used and published on our public/private social media platforms. Do you consent for WBSLSC to use pictures from this course and publish them on various social media platforms including, Facebook, Instagram, Club Website, Newspapers/Newsletters etc.
*
Yes
No
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Section 5: Terms & Conditions
More information will be provided by the course coordinators prior to the course. If you have any queries, please contact chiefinstructor@woolamaibeach.asn.au
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Ok
Is all the above information correct? Incorrect/Misleading information could result in your registration being discarded, and your position offered to someone on the waitlist.
*
Ok
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Payment: Please note, if the registration fee has sold out, we have reached our registration capacity and you will need to register for the waitlist. We have unfortunately been forced to review and increase our course prices this season due to clubhouse fees, equipment repairs and cleaning fees, causing the SRC course to increase by around 12%.
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( X )
SRC Course Registration Fee
Enter description
$
270.00
AUD
Waitlist
$
Free
AUD
Credit Card
Any questions or concerns regarding registration can be directed to cheifinstructor@woolamaibeach.asn.au, if you don't have concerns, please wait for us to contact you with more details!
*
Ok
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