Training & Courses
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Ithaca - Caloundra City Life Saving Club Inc
Course Registration Form
to down load an information brochure.
Grey Medallion Enquiry / Registration
Please complete the below form to enquire or register to attend the next Grey Medallion course.
to find out more information about the Grey Medallion.
Please select a course date
Saturday 28 & Sunday 29 July 2018
Saturday 18 & Sunday 19 August 2018
I am enquiring only
at BreakFree Grand Pacific, 100 Bulcock Street, Caloundra
9am to 4pm
Please complete one form for each person
Please enter your name:
What is your gender ?
I do not wish to specify
Please enter your email address:
Please enter your phone number:
Are you enquiring or registering?
Neither, please contact me about the course
If an emergency occurs, who should we contact:
Emergency Contact Name:
Contact Telephone Number:
Please let us know about any disabilities you have, or special arrangements we may need to make for you:
Please enter any messages or questions:
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© Ithaca - Caloundra City Life Saving Club Inc ABN 69 400 598 562
29 The Esplanade, Bulcock Beach
PO Box 1648, Caloundra Qld 4551