SRC - Bronze School Holiday Intensive - Oct

SRC - Bronze Intensive Course

October School Holidays 2025 - Application Form
WAITLIST OPPORTUNITY

Applications for the SRC- Bronze Course have closed, and selection notifications have been sent to successful members.

That said, we have opened a waitlist for those still keen to potentially be involved. To be considered for the waitlist, members MUST meet ALL of the requirements, including providing their sighted 400m swim time as part of the application.

As confirmation may not occur until the last minute, it is recommended that you start the SRC - Bronze e-learning (SLS Hub) now. Access to the Provide First Aid e-learning won't occur unless you have been selected into the course. Please be mindful of the Provide First Aid eLearning, takes 4 hours.

If you are offered a spot in the course, you will receive a phone call from SLSSA Member Ed team member.
Participant Details
Name*

First NameLast Name
Birth Date*

DayMonthYear
Club: *
Mobile Number*
E-mail*
Do you already hold a current Provide First Aid Certificate

Yes, gained with SLSSAYes, gained with another providerNo
If yes, please provide a copy of the certificate

Cancelof
Pre-Requisites

All are required at the time of application. If any of the pre-requisites are not met, you will not be selected into the course.
Are you recorded as SRC proficient on Surf Guard AND have gained at least 10 patrolling hours:*

YesNo - you will not be selectedUnsure
400m Swim Time*
Sighted by: *
Must be a Club Bronze Trainer, Assessor or Endorsed Delegate (such as the Club’s Swim head coach)
Third Party Report

Cancelof
Club Support

Please provide the details of your Club Captain, Chief Instructor or President. They will be asked to support your application.
Name of Club Rep*

First NameLast Name
Club Rep Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Their Role:*

Club CaptainChief InstructorPresident
Site Location

Due to demand, we opened a second location at Grange. Please indicate your preferred location. If a spot opens up at a particular locations, those that can attend that spot will be considered.
Preferred site location:

Glenelg SLSC onlyGrange SLSC onlyCan atte4nd either location
Medical Requirements

Please provide the following information so that we can best support your involvement in the course.
Do you have any medical, respiratory, physical or learning conditions which our facilitators should be aware of to best support your involvement?*

YesNo
If yes, please provide details:
Emergency Contact
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to the participant*
If the participant is under 18, please provide an email of a parent/guardian who will also receive all relevant communications
example@example.com
Transportation

If the participant is under 18, in line with SLSA Child Safe Policy, please indicate transport permission your child has and will be using to attend the course
Transport permissions

Will be dropped off/picked up by parent ONLYHas permission to catch public transportHas permission to driveHas permission to walk/ride bikeHas permission to transport with friendTransport has not been organised at this point but understand it is the parent/guardian's responsibility to communicate permissions via email, once confirmed
Any additional questions or comments?
Terms and Conditions
Declaration and Signature*

Clear
By signing below, you declare that you intend to complete the course and provide continuous support to the SLS club
Should be Empty:

SRC - Bronze Intensive Course

Participant Details

Pre-Requisites

Club Support

Site Location

Medical Requirements

Emergency Contact

Transportation

Terms and Conditions