Summer of Surf
Expressions of Interest and Registration
Child #4 Name:
Medical Conditions of Note - Please state the child’s name, the medical condition and specific treatment required.
I have some questions (please complete below)
Your child(ren) will need the following each day:
Togs and towel
Wetsuit optional but recommended
Warm clothes to change into after water-based activities
Drink bottle (water)
Hat or cap
We recommend you apply sunscreen before starting. We provide sunscreen during the sessions and the lifeguard coaches will remind children to reapply.
If not registering for full weeks, please complete.... I would like to register my child(ren) for the following days. Please clearly list dates you would like.
Please register my child(ren) for the following dates
Week of 6 - 10 January
Week of 13 - 17 January
Week of 20 - 24 January
I’m interested in some days. Please give details below.
Please contact me to discuss.
Child #1 Age:
Member of Waihi Beach Lifeguard Services, Junior Surf
Child #4 Age:
Child #2 Age:
Child #1 Name:
Contact Mobile Number:
Emergency Contact - Name & Mobile Phone
Child #3 Name:
I give permission for my child(ren) to be transported in a Club or private vehicle if required due to weather conditions at main beach to take the group to Anzac Bay. All vehicle drivers have a full, clean driver's licence. This may not be necessary unless excessive wind or surf conditions make it safer to operate at Anzac Bay.
Child #3 Age:
Please register my child(ren), details below:
Child #2 Name:
We will invoice you for sessions, but request that you make payment in advance. Eftpos/Credit Card payment available if required at the Club when signing in children.
I understand that full payment is required in advance. Weekly payments may be made prior to the start of each week’s sessions.
Online payments to:
A copy of your responses will be emailed to the address you provided.
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