Lifesaving Regional Capability Building Workshop
Please fill out this form to register your attendance for the upcoming Workshop.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Club
*
Position(s) Held in Club/Branch
*
Which Workshop are you registering for?
*
Please Select
Tannum Sands - 12th September
Mission Beach - 19-20th September
Townsville - 17-18th October
Mackay - 24th-25th October
Mooloolaba - 21st November
Please Note you can only register for one workshop.
Why do you want to participate in the Lifesaving Regional Capaility Building Workshop?
*
Shirt Size
*
Please Select
XS
S
M
L
XL
XXL
3XL
4XL
5XL
Note: these are Unisex Sizes
Dietary Requirements/Allergies
SMAR - NQ and NBB Region ONLY
Are you interested in SMAR qualification? Please note that there is a 400m swim pre-requisite required.
Yes
No
Acknowledgement
I understand that if I register and do not attend this workshop, a $50 no-show fee will be charged to my relevant club.
I understand
Signature
*
Continue
Continue
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