Application Form
Event: Dorians Coastal Challenge powered by Hellenic Bank
Date: 8th April 2017
Venue: CTO Beach, Larnaka
Arrival time at Venue: 06:30
Email address
Name:
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Surname:
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E-mail Address
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Date of Birth:
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Gender:
Telephone:
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Full Address (Street Number, Address and Post Code)
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City:
What Volunteer Role would you like to have (only available position):
T-shirt Size:
Do you have any health problems?
If you do not have any health problems, please write NO at the box below. If you have any health problems such as diabetes, asthma, etc. or disabilities, please provide as many information as possible below. We will only use this information in the event of a medical emergency which leaves you unable to speak to medical professionals. It is very important that you fully disclose all information.
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Do you have any skills or interests relevant to the Volunteer Role(s) you apply?
If you have any skills including valid first aid diploma(s), valid lifeguard diploma(s), rescuing, CPR certification and computer skills (MS Word, Excel, PowerPoint etc.) or interests such as climbing, please do let us know. If NOT, simply write NO below.
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Emergency contact name and surname:
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Emergency contact telephone:
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Relationship with emergency contact:
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Electronic Signature (Full name and surname):
By signing below, I certify that all the information I have provided here is accurate and true. I also verify that I have read, understood and accept the terms and conditions, the privacy policy and the Dorians Coastal Challenge Volunteer Waiver Agreement.
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