Clone of SRC - Bronze School Holiday Intensive

SRC - Bronze Intensive Course

September School Holidays 2026 - 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
Format: 0000 000 000.
E-mail
Preferred course location
Do you already hold a current Provide First Aid Certificate
If yes, please provide a copy of the certificate

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Pre-Requisites

Pre-Requisites are required at the time of application other than the Swim which is due on 21 of September. 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:
Third Party Report
Third Party Report PDF: please download the form, complete it, and upload the finished copy here.
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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.Format: 0000 000 000.
Their Role:
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?
If yes, please provide details:
Emergency Contact
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: 0000 000 000.
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
Any additional questions or comments?
Terms and Conditions
Declaration and Signature

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

Third Party Report

Club Support

Medical Requirements

Emergency Contact

Transportation

Terms and Conditions