Surfguard Access Request
Surfguard users full name:
*
First Name
Last Name
Surfguard users preferred mobile:
*
Used for secure login
Format: 0000 000 000.
Surfguard users preferred email:
*
Used for Surfguard notifications and password resets, preferably not a club or organisation email address.
Surf Club:
*
Please Select
Tea Gardens Hawks Nest
Fingal Beach
Birubi Point
Stockton
Nobbys
Newcastle
Cooks Hill
Dixon Park
Merewether
Redhead
Swansea Belmont
Caves
Catherine Hill Bay
Club Position:
*
Please Select
President
Secretary/Admin
CTO/Education
Club Captain/Lifesaving
JAC/Juniors
Other
Please specify club position:
*
Additional access required and justification:
Endorse by signing below or attaching evidence (completed form 49 or club letter head):
Signing below
Attaching evidence
Club endorser full name:
*
First Name
Last Name
Endorsers email
*
example@example.com
Signature
*
Please attach evidence
*
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