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Application form for the next pool lifeguard course taking place at Langford Sports Centre. Call 449617 to book or email [email protected]
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National Pool Lifeguard Qualification Foundation Module & Unit 2
The Royal Life Saving Society’s National Pool Lifeguard Qualification is a professional qualification valid for 2 years after date of assessment. In order to maintain the qualification it is essential that you attend lifeguard training on a regular basis. You are required to have 20 hours logged training in order to re-take the exam. It is suitable for competent swimmers only aged 16 years and over. You will need Shorts and T-shirt to swim in, swimming costume, 2 towels, 20p for the locker, plenty to drink and a packed lunch with snacks for throughout the day.100% attendance is required. Applications are processed on a first come, first served basis. All course materials and assessment fees are included. Assessment times will be arranged during the course. Dates: Sunday 1 April – Thursday 5 April (Foundation Module) & Saturday 7 April (Unit 2) Time: 9am – 5pm (includes breaks) Course Fee: £208 Course Venue: Langford Sports Centre Course Tutor: Christina Blampied
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Application for Pool Lifeguard Course (reference 1685) Name: Date of Birth:
Home Address:
Post Code:
Tel. Day: Tel. Eve:
Emergency Contact Name & Tel. Number:
Please List Recent Vaccinations & Health Record (inc. any allergies, statement of special needs, etc.):
Method of payment: Cheques should be made payable to “Treasurer of the States”. Or Credit/Debit card number
Valid From / Expiry Date / Issue No.
Name of Cardholder
Cardholder’s Signature
Parent’s Signature: Date:
Please return to: Sports Development, Fort Regent, St. Helier, Jersey, JE2 4UX
facebook.com/sportsdevelopmentjersey tweet us @JerseySport [email protected] www.gov.je/sport
