SSC Operations Support Club RWC Operator "Skills Session"
This form is used to request a session for an operator after completion of an RWC Course
Club Name
*
Please Select
Rainbow Beach
Noosa Heads
Sunshine Beach
Peregian
Coolum Beach
Marcoola
Mudjimba
Maroochydore
Alexandra Headland
Mooloolaba
Kawana Waters
Dicky Beach
Metropolitan Caloundra
Bribie Island
Redcliffe Peninsular
Club Captain Name
*
First Name
Last Name
Club Captain mobile #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Club RWC/Powercraft Officer Name
*
First Name
Last Name
Club RWC/Powercraft Officer Mobile #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Club RWC Operator name
*
First Name
Last Name
Club RWC Operator Mobile #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Club RWC Operator Email
*
example@example.com
Date RWC Award Certificate Received:
*
-
Month
-
Day
Year
Date
Club RWC Brand and Model
*
eg Yamaha GP1800, Seadoo Spark etc
RWC Vessel Registration Number
*
RWC Trailer Registration
*
Confirm that this craft RWC and trailer is noted on the club insurance policies.
*
YES
NO
Suggested possible dates for ‘skills session’.
*
Please offer 3 future dates as options
Approved for submission by Club Captain
*
YES
NO
Submit
Should be Empty: