Trust Waikato Waihi Beach Lifeguard Services Inc E: info@waihibeachlifeguards.co.nz P: 07 863 5108 W: waihibeachlifeguards.co.nz

REGISTRATION FORM – 1 June 2014 to 30 May 2015 CHILD / LIFEGUARD (ACTIVE) FEES – RECEIPT NUMBER

First Surname Male/ Female

Date of

birth

Age at 1/10/14 SLSNZ #

Medical conditions or allergies

Participant’s email & mobile (All active members under 18 please provide parent’s

email address)

PARENTS / GUARDIANS / ASSOCIATE / SOCIAL ADULT MEMBERSHIP

First Surname Associate Social SLSNZ# Medical conditions or allergies

Mobile Number

ADDRESS (home) ADDRESS (holiday location – Waihi Beach)

EMAIL (parent 1)

EMAIL (parent 2)

Comments

Emergency Contact Name

Phone No

I give permission for club photographs involving our family to be used for media purposes promoting Waihi Beach Lifeguard Services.

Y / N

MEMBERSHIP CATEGORIES

Cost $ SLSN

Z N

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8yr

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sho

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Kit

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IRB

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Bo

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area

Bar

, dec

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lou

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Acc

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mo

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ion

(1

6 y

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+)

Gym

Total ($)

Lifeguard (14 years +) $ 60

Associate $ 45

Social $ 25

Junior surf $ 50

Family Membership - social 2 social adults & 2 active members Additional active members $25

$ 140

Family Membership - associate 2 associate adults & 2 active members Additional active members $25

$ 180

Early bird payment discount Payment of invoice by 22 October 2014 to qualify 10% discount $

TOTAL $

SPORTS EQUIPMENT Please indicate your interest in the following sport/equipment so we can allocate accordingly. Please indicate your requirements prior to the start of the season to assist with allocation. Very interested Somewhat interested Not interested

Foam board hire

Fibreglass board hire

Ski hire

Canoe hire

IRB Racing

Surf Boats

Comments:

Received board policy Signed board policy Received Equipment Care & Maintenance Sheet

Summary Adults Children Total Amount Receipt/Invoice No: Number of

Payment cheque cash internet part payment $

Comments (any preferences)

CLUB CLOTHING & MERCHANDISE ORDER FORM (swimwear available for collection Labour Weekend)

NAME_________________________________________ Phone No: ____________________________________

An invoice will be actioned on receipt of your registration form.nternet banking payments to account number 03 1576 0021159 00 with surname

indicate fees/uniform/equipment.

Back Order/Notes

_______________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________

CLUB CLOTHING Price Size Quantity Total $

Taken (sign)

LIFEGUARDING (red/yellow)

Price Size Quantity Total $ Taken (sign)

Ladies 1-piece $75 Shorts $ 22

Ladies bikinis $ 85 Polo shirt $ 15

Girls 1-piece $ 70 Rash shirt $ 30

Girls bikinis $ 80 Jacket $ 65

Girls jammers $ 50

Mens brief togs $ 45 Wide brimmed hat $ 10

Mens jammers $ 65 Manuals/workbooks $ 15

Boys brief togs $ 40

Boys jammers $ 60Rash shirt (blue/white) $ 45 MERCHANDISE

Safety Hi-Vis vest $ 16 Surf NZ towel $ 30

Skull cap (small) $ 10 Gear bag - named $ 45

Skull cap (large) $ 12 Back pack $ 35

Club singlet $ 30

Club shorts $ 30 Club hoody – adult $ 55

Club hoody - child $ 45 Club polo – adult $ 40

Club polo shirt - child $ 35 Club singlet - adult $ 35

Club beach coat $147 Club shorts – adult $ 35

Total $ $

Compulsory uniform Togs, skull cap & hi-vis vest (competitions) Rash shirt recommended

Total uniform costs $

Payment internet cheque cash part payment $ Invoice No: Payment received:

Members of Trust Waikato Waihi Beach Lifeguards Services Inc

Code of Conduct

PREAMBLE

The Waihi Beach Lifeguard Service (Club) has been established by the community to provide life saving services to benefit beach users at Waihi. Our members share a mutual interest and respect for the objectives of the Club and a respect for one another.

This Code of Conduct is to provide firstly a basis as to how members should conduct themselves, and secondly, to ensure a safe environment for the mutual benefit of the membership as a whole.

Our membership is open to all those fulfilling membership criteria

Privacy of individual members is to be respected. Personal information collected is for use within our organisation and is not available toothers

No member should conduct themselves in a manner likely to give offence or cause harm to others

The safety of all members is paramount. No member will put other members at risk, either physically or emotionally

Respect for club property. It is yours. Clean and put away all equipment. Clean, close and lock the entire club when leaving the club

Respect the feelings of others, and consider your actions and their effects on others

Remember, we rely on the community for support. Your actions as a member may impact on the way the community views us.

It is the policy of the club to provide a healthy and safe environment for all members.

Harassment in any form will not be tolerated.

Participant: Signature: ____________________________________________ Parent: Signature___________________________________

Date: ____________________________________________

If under 18 years old

* Listen to your coach/s and follow their instructions.

Item Description Picture Sizes Beach Towels

In it for life – 100 year

celebration

One size

Gear Bag – named

Medium capacity for all of

your gear.

One size

Swim Goggles

Ideal for surf swimming,

anti fog.

Great value.

One size

Beach Coat

Ideal to keep the swimmer

warm after exercise. Fleece

on the inside, parka material

on the outside.

Named & club logo

Childrens 10y 12y 14y 16y

half chest 51.5 54 56.5 59

back length 94 96 98 100

sleeve length 67 70 73 75

Mens/Ladies S M L

half chest 61.5 64 66.5

back length 104 106 107

sleeves length 78 80 82

All measurements in cm

Club Singlet

Summer friendly material.

Nice design.

Mens & ladies styles

Name on reverse.

Childrens

6, 8, 10,12,14,16

Ladies

6, 8, 10,12,14,16

Mens

S, M, L, XL

Club Cap

Washable, breathable cap

with adjustable strap.

Keep the sun off your face.

One size

Un

ifo

rm C

atal

ogue

Item Description Picture Sizes

Club Polo Shirt

Breathable fabric complete

with club logo. Includes name

printed on the shirt.

Childrens

6, 8, 10,12,14,16

Mens/Ladies

S, M, L, XL, 2XL

Club Hoodie

360gsm fleece

classic fit. Lined hood, pouch

pocket. Name printed on the

hoodie. Club logo included.

Childrens

6, 8, 10,12,14,16

Ladies

S, M, L, XL

Mens

S, M, L, XL, 2XL

Club Shorts

Breathable fabric complete

with club logo

Childrens

4, 6, 8, 10,12,14,16

Mens/Ladies

S, M, L, XL, 2XL

Safety Hi-Vis Vest

Must be worn when competing

& during water based training.

Colour may be different to

picture.

Childrens

10,12,14,

Mens/Ladies

XS, S, M, L, XL, 2XL, 3XL

Jammers

Suitable for all competitors.

Worn alone or over togs.

Can be worn to competitions.

Male & Female Styles

S, M, L, XL

Un

ifo

rm C

atal

ogue