levei 2 testing - Level 1 Surfing Instructor

Personal Information

Title *

First Name *

Middle Name *

Surname *

Gender *

Male

Female

Date of Birth *

Country of Birth *

Town/City of Birth *

Referred by *

T-shirt Size *

Address & Contact Details

Street Address 1 *

Street Address 2 *

Town/City *

Postal Code *

Country *

Email Address *

Phone *

Next of Kin - Full Name * Please provide the details of a next of kin or emergency contact.

Next of Kin - Phone Number *

Address & Contact Details

Street Address *

City *

State/Province *

Postal Code *

Country *

Email Address *

Phone *

Next of Kin - Full Name * Please provide the details of a next of kin or emergency contact.

Next of Kin - Phone Number *

Selection Criteria

Which surf or bodyboard school will you complete your practical hours with or write “none” if no school at the moment*

How long have you been bodyboarding (number of hours)?*

What is your skill level?*

Beginner-paddle & kick correctly with board in trim. 1½ ft (½ metre) surf

Intermediate-perform trimming, right-hand & left-hand turns, forward & reverse spin, roll. Below lip. 3ft (1 metre) surf

Advanced-perform air, ARS (air, roll, spin), 360 spin forward/reverse, backflip, drop knee tail slide and floater. 3ft (1metre) to 6ft (2 metres)

Elite-perform all manoeuvres listed above in 6ft (2 metre) plus surf, all types of surf breaks

Experience & Qualifications

List your bodyboarding experience including types of surf breaks and condition you have surfed and any competition experience:* Please list any relevant qualifications or certifications.

List your bodyboarding instruction experience:* Please describe your relevant experience.

List any other instructor or training qualifications you have (or write “none”):* Please describe your relevant experience.

List any surf rescue and senior first aid qualifications that you have (or write “none”)* Please describe your relevant experience.

Reason for Study. Write down in not less than 50 words why you would like to undertake this course (e.g work related, personal development)* Please describe your relevant experience.

Education Department Statistical Data

Unique Student Identification Number (USI)* Students must have a USI. OR you can skip this field and supply it to us later. Write "NONE" The USI is issued by the Australian Education Department. Obtain a USI

Are you an Australian Citizen?*

Are you an Australian Resident?*

Are you of Aboriginal / Torres Strait Islander Origin?*

Are you still in school?*

Yes

No

What is your highest completed school level?*

What year did you complete that level?*

Have you completed any of these qualifications?*

Which of these options best describes your current employment status?*

Which best describes your main reason for undertaking this course?*

Do you speak a language other than English at home?*

Yes

No

How well do you speak English?*

Are you interested in accessing support to improve your English if help was available?*

Yes

No

Do you have a disability, impairment or long-term condition?*

Applicant Declaration

ASI abides by the Privacy Act. The information collected in this application is for the purposes of registration, program monitoring and evaluation. In supplying the requested information, the participant is deemed to have consented to the use of the information for these purposes.

I certify that the information supplied in this enrolment form and the documentation supporting it is true and correct. I understand that any incorrect information or withholding of information or documentation may result in the cancellation of any enrolment.

Student Indemnity Agreement

IN CONSIDERATION of the Organiser permitting me to participate in the training course, I agree with it as follows:

1. I UNDERSTAND that participating in any type of training or course or activity may be DANGEROUS and I voluntarily ACCEPT the risk of damage consequent upon or arising from my entry as a student, and the use of the Organisers facilities.

2. I WILL NOT SUE the Organisers for any negligence, tort, breach of contractual or any other legal or equiptable rights howsoever caused, and this indemnity will extend to and include any damage arising from my competing in training and from my use of the Organiser’s facilities and I INDEMNIFY the Organisers in respect of the same.

3. I WILL abide by the Rules and Regulations of the Organiser’s as to the training and to the use of the Organiser’s facilities and the directions of the Organiser’s officials including the right to terminate or cancel my training and the use of the Organiser’s facilities at any time and for any reason.

4. THE PERSONAL INFORMATION I have supplied to the Organiser regarding my qualifications, experience, and any other matter associated with the training is true and correct and I have READ AND UNDERSTOOD all of the clauses of this agreement before signing the same and before my use of the Organisers facilities.

5. IN THE AGREEMENT the following words shall respectively mean “the Student” the person named as such on the enrolment form accompanying this agreement. “the Organiser” is the Academy of Surfing Instructors Pty Ltd (including any associated campus or organisation) any Training Facilitators/Assessors, lecturers, directors, officers, managers, advisors, employees, agents, licensees, sub-contractors, subsidiaries, holding companies, associates and assignees, or any person associated with the company or person in any way. “:the Organiser’s facilities” the water, land and buildings associated with any training or any part of the training, weigh-in, media conference, accommodation or training venue. “use of the Organiser’s facilities” the use by the student or his attempted use of the Organiser’s facilities whether such use or access is in breach of this agreement of the Organiser’s Rules and regulations or authorised or otherwise and whether intended to be so used or no. “Damage” all loss or damage, costs or expenses, whether direct or indirect flowing from any legal liability, claim, demand, right of action, proceedings or judgment of whatever nature and whether arising at law or in equity and whether suffered to the person or property of the Organiser, the Student, or any other person or corporation and whether arising out of or consequent upon the negligence of the Organiser, the Student or otherwise. “Rules and Regulations” are the Rules and Regulations relating to any Training which are available from the Organiser, and include all amendments or alterations to the Rules and Regulations made from time to time.

Student Information and Code of Practice

I have read and agree to be bound by the terms contained in the : Student Information and Code of Practice

Refund Policy

I have read and understood the refund policy as it applies the course I have enrolled in. Refund information is listed on the enrolment information. More info at: https://www.academyofsurfing.com/refund

Declaration Confirmation

I have read and understood

Application Declaration

Student Information and Code of Practice

Indemnity Agreement

Refund Policy

PAYMENT INFORMATION

Payment Amount: AUD$475

Special Fee: AUD$300

Promo Code:

Total Amount: AUD 0.00

Payment Method *

Credit/Debit Card

Bank Transfer

Other

Card Number

Expiration Date

Security Code

Confirmation & Review

Enrolment Nearly Complete!

Thank you for your application. We will confirm your enrolment and send out training details once we have received payment. levei 2 testing - Level 1 Surfing Instructor.

If you have paid by credit card:

Account Name: Academy of Surfing Instructors Pty Ltd

Bank Name: Commonwealth Bank of Australia

BSB: 062 000

Account No: 11156322

Swift Code: CTBAAU2S

There is no IBAN number in Australia.

Please email us when you make payment so we can check the bank account.

Once payment is received, we will send you confirmation of enrolment.

I confirm that all the information provided is accurate and complete *

Once you submit this form, you will receive a confirmation email with your enrolment details and login information to access the online platform.