Silver Medallion Patrol Captain Registration 2026
The Silver Medallion Patrol Captain is an award that provides participants with the skills and knowledge to lead in beach operations.
Participant Details
Name
*
First Name
Last Name
Birth Date
*
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2026
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Year
Gender
*
Please Select
Male
Female
N/A
E-mail
*
Mobile Number
*
Format: 0000 000 000.
SLSSA Club:
*
Please Select
OTHER/UNSURE
ALDINGA BAY
BEACHPORT
BRIGHTON
CHITON ROCKS
CHRISTIES BEACH
GLENELG
GOOLWA
GRANGE
HENLEY
MOANA
NORMANVILLE
NORTH HAVEN
PORT ELLIOT
PORT NOARLUNGA
ROBE
SEACLIFF
SEMAPHORE
SOMERTON
SOUTH PORT
WEST BEACH
WHYALLA
Are you:
*
Please Select
Current Patrol Captain
Current Vice Captain
EOG Duty Officer
General Member
Are you applying as a participant or to be a probationary trainer?
Participant
Probationary trainer or facilitator
SMPC Requirements
Please confirm that you meet the pre-requisites of the course, which course you would like to attend, your motivations for wanting to gain the award
Which course date would you like to attend:
*
Course 1: 29th & 30th August
Course 2: 29th August & 5th September
Able to commit to either dates
Brief explanation of why you would like to become a SMPC Trainer or Facilitator:
*
Brief explanation of why you would like to obtain the SMPC award:
*
Do you meet all of the following pre-requisites needed to attend the SMPC course? (see terms and conditions on the Circular for details)
*
18 years or older
Proficient in Bronze Medallion
Two years of patrolling experience
Do you meet the following pre-requisites needed to train the SMPC Course
*
Holds a current TAE qualification
Holds current First Aid Certificate
Holds current CPR Certificate
Holds current National Police Check
Holds current Working With Children Check
Proficient in Silver Medallion Patrol Captain Award
Third Party Report
Browse Files
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Please provide, if you have a completed form. If not, this can be provided up to 6 weeks after the face to face sessions.
Cancel
of
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 Representative
*
First Name
Last Name
Club Rep Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: 0000 000 000.
Their role:
*
Club Captain
Chief Instructor
Club President
Medical and Dietary Requirements
Please provide the following information so that we can best support your involvement in the course.
Do you have any dietary requirements or medical, physical or learning conditions which our facilitators should be aware of to best support your involvement?
*
Yes
No
If yes, please provide details:
Emergency Contact
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Relationship to the participant
Terms and Conditions
Any additional questions or comments?
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