Applications - BULSCA by wangnianwu


									                                                                                                                              Laura Mitchell
                                                                                                BULSCA Beach Lifeguard Weekend
                                                                                                2 Comfortable Place, Bath, BA1 3AJ
                                                                                                                            07827 970529
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                   British Universities’ Beach Lifeguard Weekend 2013 (3-6 May 2013)
University lifesavers from across the UK will be coming together in Bournemouth for the BULSCA
Beach Lifeguard Weekend 2013, and we want YOU to join us! During the weekend you will sample
a range of beach lifeguard skills (including open-water swimming, rescue boarding and power
boating) and train to become a “Sea Safety Instructor” – all for just £45.
Most of the beach lifeguard weekend will be devoted to sampling practical lifeguard skills. We’ll
split into groups and rotate around a number of beach lifeguard activities (including open-water
swimming, rescue boarding, lifeguard patrol skills, beach sprints, power boating and more to be
confirmed). But there is also an important water safety aspect to the event...
Prior to the weekend, BULSCA and the Royal Life Saving Society (RLSS UK) will help your club to
form links with local schools and community groups. During the weekend itself, you’ll receive
training and resources from RLSS UK staff which will allow you to deliver an interactive sea-
survival awareness session to your partner organisation. This will raise the profile of your club, and
will help to counteract the surge in drowning that often accompanies the summer as families head
to the coast on holiday. This drowning prevention project has been subsidised by a grant from the
Royal National Lifeboat Institution.

The BULSCA Beach Lifeguard Weekend is a great way to get to know lifesavers from other clubs,
and sample open-water lifesaving under the guidance of experienced instructors. It’s also a superb
opportunity to put something back into your local community and help reduce the number of
drowning in the UK. So what are you waiting for? Sign up now...
Where:                   Bournemouth
When:                    7:30pm on Fri 3rd May 2013 to 10am on Mon 6th May 2013

Cost:                    Register by 17 Feb for a special early-bird rate of just £45 (normal price £55).
                         This includes: all activities at the beach (open-water swimming, rescue boarding,
                         power boating plus others to be confirmed); 3 nights’ accommodation; breakfast
                         on Sat & Sun; evening meals on Fri, Sat & Sun; polo shirt.
Refunds:                Refunds will only be offered if there is a direct clash with a participant’s exams
                        (evidence required).
Pre-requisites: For insurance purposes this event is only open to RLSS members or members of
                BULSCA clubs that are affiliated to the RLSS. Participants must be able to swim
                200m fully clothed. There are no pre-requisite awards required.

Should you wish to reserve a place on this trip please complete the consent form (below) and
return it by 18 Mar 2013 with a cheque for £45 (or £55 if you are returning the form after 17th Feb)
made payable to The Royal Lifesaving Society. Places will be allocated on a first-come first-
served basis. For more information, please see or drop me an e-mail.

          Laura Mitchell
          BULSCA Beach Lifeguard Weekend Coordinator
                                      Consent Form
                       BULSCA Beach Lifeguard Weekend (3-6 May 2013)
A separate consent form must be completed for each participant and returned by 18 Mar 2013.
To ensure the safety and welfare of participants, the information you provide will be shared with
the event leaders. Please complete the form CLEARLY in BLOCK CAPITALS using a BLACK
pen. Illegible or incomplete forms will be rejected.

                                     Participant’s Details

Full Name:                                                      Club:
Date Of Birth:                                                  Sex:         Male / Female
Home Address:
Landline Phone:                                      Mobile Phone:
Participant’s Email:

What size polo shirt do you want? (Please tick)
 Small (35/37)         Medium (38/40)      Large (41/43)       XL (44/46)      XXL (47/49)
What single-word name/nickname would you like on the front of your sweatshirt?


Participants must be individual members of the RLSS, or members
of a BULSCA club that is affiliated to the RLSS. Please enter your
RLSS number or your club’s RLSS number here:
Please tick to confirm that you can swim 200m fully clothed:

                               University Lead Point of Contact

Each club is required to nominate a lead point of contact who will be
attending the weekend. Please write their name here:

                                  Emergency Contact Details

             Emergency Contact 1                                Emergency Contact 2
Full Name:                                         Full Name:
Relationship to                                    Relationship to
Participant:                                       Participant:
Landline Phone:                                    Landline Phone:
Mobile Phone:                                      Mobile Phone:

Doctor’s Name:                                    Doctor’s Phone:
                                   Participant’s Medical Details

Do you have any medical conditions which may affect participation in this trip
                                                                                       Yes / No
(e.g. asthma, epilepsy, diabetes, allergies, muscle injuries, etc.)?
Are you taking any medication?                                                         Yes / No
Do you have any disabilities or other special needs which may affect
                                                                                       Yes / No
participation in this trip?
Do you have any special dietary requirements?                                          Yes / No

If you answered “yes” to any of the previous questions, please provide full details below...

                                         Prior Experience

Please provide information about any prior experience or qualifications that you hold. This
information will be used to mix experience/ability in each group.



Other relevant qualifications & experience...
                                       Participants Consent

I have read all the information provided. I give my consent for the event organisers to contact
me by letter, text message, e-mail, telephone and Facebook in relation to this event.
I give permission for the event organisers to give the immediate necessary authority on my
behalf for any medical or surgical treatment recommended by competent medical authorities,
where, in the doctor’s medical opinion, it would be contrary to my interests for any delay to be
incurred by seeking my personal consent.
I understand that while the event organisers will make every effort to ensure my safety, they
cannot be held responsible for any loss, damage or injury suffered during, or as a result of the
trip. I confirm that I am in good health and I consider myself fit to participate. I will inform the
organisers if there are any changes in these personal details or medical conditions.
I give my consent to be photographed and videoed during the trip and for the resultant images
to be used to produce posters, DVDs and articles to promote lifesaving and to be included in a
report on the internet (including the BULSCA website and Facebook Group).
I understand that I am representing BULSCA during the exchange and will behave in an
appropriate manner at all times.

Signed:                             Print Name:                         Date:

Please return the completed form to:
      BULSCA Beach Lifeguard Weekend, 2 Comfortable Place, Bath, BA1 3AJ
Please include:
       One passport style photos
       A cheque for £45 (or £55 if you are returning the form after 17th Feb) made payable to
      The Royal Lifesaving Society

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