BOP & CORO IRB Driver INSTRUCTORS clinic (including season briefing)
Registration Form to attend the IRB driver Instructors clinic at Papamoa SLS on Saturday 01 Oct
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Full name *
Club *
Date of Birth *
MM
/
DD
/
YYYY
SLSNZ Membership #
Email Address *
Mobile Number *
Are you a refreshed lifeguard? *
Are you a refreshed IRB driver *
What is your current level of involvement in IRB Driver development in your club / region?
How would you rate your IRB Instructing abilities on the below scale
I am brand new to Instructing IRBs
I'm ready to move on to / am an IRB Examiner
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Do you have any special dietary requirements or allergies?
Do you have any medical conditions? *
Emergency Contact Information. Name & Relationship *
Emergency Contact Mobile Number *
Confirmation of your registration to attend will be sent once registrations have closed, if you have any further details or comments you wish to make please use the space below or email Robynne or Dominic directly.

robynne.cabusao@surflifesaving.org.nz
dominic.sutton@surflifesaving.org.nz
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