To express an interest in participating in a Silver Salties program, please complete the relevant details in this form. We cannot guarantee that your local Surf Life Saving Club will run any/all of the Silver Salties programs that you are interested in - we will communicate your interest to clubs in order for them to plan and schedule programs.

Question Title

* 1. Name

Question Title

* 2. DOB

Question Title

* 3. Mobile Number

Question Title

* 4. Primary Contact Email

Question Title

* 6. Postcode

Question Title

* 8. Club Name (if member of a club)

Question Title

* 9. What is your current level of physical fitness?

Question Title

* 10. Programs

Please select all the programs you are interested in - Click Here for a summary of available programs.

Question Title

* 11. Comments/Questions

Thank you for taking the time to submit your expression of interest in Silver Salties. For further information about Silver Salties please contact SLSA Participation Manager: jpalmer@slsa.asn.au
0 of 11 answered
 

T