Date: 19th February - Venue: Mt Maunganui

Please ensure that clubs supply a 1 Instructor/Club Rep to 5 Candidate ratio for water safety. 

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* 1. Full Name

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* 2. SLSNZ Membership Number

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* 3. Contact Email

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* 4. Club

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* 5. Attending as

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* 6. Club Instructor Name

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* 7. Club Instructor Email

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* 8. Club Instructor Mobile

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* 9. You will need to bring the following things with you to the exam

  I will bring this with me to the exam I will make sure I bring this with me to the exam
Completed & Signed off Workbook
A Pen
Swimming Gear (togs, towel, goggles)
Fins
Rescue Tube
Club Instructor or Representative

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* 10. Please acknowledge you have read the following:

"If you do not have the prerequisites will not be able to attend the exam."

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