RIPCURL Girls Go Surfing Day
Which Surf School will you be attending: Great Lakes Surf School Name: Age: Address: Suburb: Ph #: Email: Do you own your own wetsuit? YES / NO (please circle) Can you swim 50 metres? YES / NO (please circle) Please list any medical conditions that may effect your participation: State: Mob #: P’Code: DoB:
1 & 2 December 2007
ENTRY FEE: $40 (inc gst) YOU GET: - Learn to surf less - Board and wetsuit hire - Showbag - Rip Curl singlet Enter by sending this entry form to Great Lakes Surf School by mail at P.O. Box 665 or email to topturn1@bigpond.com. or phone Great Lakes Surf School on (02) 6552 9302 or (02) 6554 6550
DECLARATION: I agree to release the organizers, officials, sponsors, surfschools, and council or parties from any liability, loss or damage of whatsoever nature incurred whilst traveling to or from, or participating in or being present at the above named event. I understand that all officials, organizers decisions are final and that any unsportsman like conduct may result in disqualification and future penalties. I also agree to allow the use of any moving or still photo taken of me for the purpose of advertising the above named event and or by Surfing Australia Inc (SA) and Rip Curl Pty Ltd. I acknowledge and agree that the information may be disclosed by the Surf School to SA and will only be used by the Surf School and SA in accordance with their objectives and provide me with information pertaining to the Program. I understand that I will be able to access my information through the Surf School or SA upon request Signed:__________________________________________ Date:____________________ Parent/Guardian:___________________________________________ (for those participants under 18years)
Qui ckT ime™ and a T IFF (Uncompressed) decompressor are needed to see thi s pi cture.