2026 U/13 Development Camp Expression of Interest

2026 U/13 Development Camp Expression of Interest
Participant Information

19th & 20th of September
Participant full name

First NameLast Name
Preferred name
Date of birth

MonthDayYear
Date
Age at time of program
Gender
Residential address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Surf Life Saving Club
SLS membership number
Shirt size
Parent / Guardian Information
Parent / Guardian Full Name

First NameMiddle NameLast Name
Relationship to Participant
Mobile Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Residential Address (if different from participant)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact
Emergency Contact Name

First NameMiddle NameLast Name
Relationship to Participant
Mobile Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Medical & Health Information
Immunisation status
Date of last Anti-Tetanus Injection

MonthDayYear
Date
Relevant medical conditions
Full details of selected medical conditions
Upload supporting medical information

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Medicare number
Private health insurance details
Insurance company name
Other relevant medical history
Has the participant had any recent operations, injuries or illnesses?
Details of recent operations, injuries or illnesses
Special dietary requirements
Does the participant have a Medical Management Plan (e.g. Asthma / Anaphylaxis)?
Upload Medical Management Plan

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Anaphylaxis EpiPen confirmation
Additional Information
Why do you want to attend the 2026 U/13 Development Camp, and what do you hope to gain from it?
Anything else the coordination team should know
Should be Empty:

2026 U/13 Development Camp Expression of Interest

Participant Information

Parent / Guardian Information

Emergency Contact

Medical & Health Information

Additional Information