Lifesaving Regional Capability Building Workshop

Lifesaving Regional Capability Building Workshop

Please fill out this form to register your attendance for the upcoming Workshop.
Name*

First NameLast 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 Note you can only register for one workshop.
Why do you want to participate in the Lifesaving Regional Capaility Building Workshop?*
Are you interested in SMAR qualification? Please note that there is a 400m swim pre-requisite required.

YesNo
Shirt Size*
Note: these are Unisex Sizes
Dietary Requirements/Allergies
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*
Should be Empty:

Acknowledgement