JOINING MEMBERS FORMS – NIPPER FAMILIES – Queenscliff Surf Life Saving Club

New Member Proof of Age - Nippers and Parents.
It is a SLSA requirement that each joining member must verify their Date of Birth. Including NEW Nipper parents.
Number of Members Joining*
- 1
- 2
- 3
- 4
- 5
New Member 1 Name*
First Last
New Member 1 Age at 1 October 2022*

Please refer to the following page for correct age groups. https://www.queensie.com/nippers/nipper-age-groups/
New Member 1 Date of Birth*
DD slash MM slash YYYY
New Member 1 Document Upload for Proof of Age*
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 2 MB.
Please provide Proof of Age scanned photo of Birth Certificate, Passport or Drivers licence
New Member 2 Name*
First Last
New Member 2 Age at 1 October 2022*
New Member 2 Date of Birth*
DD slash MM slash YYYY
New Member 2 Document Upload for Proof of Age*
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 2 MB.
Please provide Proof of Age scanned photo of Birth Certificate, Passport or Drivers licence
New Member 3 Name*
First Last
New Member 3 Age at 1 October 2022*
New Member 3 Date of Birth*
DD slash MM slash YYYY
New Member 3 Document Upload for Proof of Age*
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 2 MB.
Please provide Proof of Age scanned photo of Birth Certificate, Passport or Drivers licence
New Member 4 Name*
First Last
New Member 4 Age at 1 October 2022*
New Member 4 Date of Birth*
DD slash MM slash YYYY
New Member 4 Document Upload for Proof of Age*
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 2 MB.
Please provide Proof of Age scanned photo of Birth Certificate, Passport or Drivers licence
New Member 5 Name*
First Last
New Member 5 Age at 1 October 2022*
New Member 5 Date of Birth*
DD slash MM slash YYYY
New Member 5 Document Upload for Proof of Age*
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 2 MB.
Please provide Proof of Age scanned photo of Birth Certificate, Passport or Drivers licence

Nipper Proficiency Levels Agreement
It is vital for Surf Life Saving Clubs to ensure their enrolled Nippers are proficient in the pool and surf, to ensure they are: SURF COMPETENT, SURF CONFIDENT, SURF SAFE Each year your child/Children must successfully complete their Age Groups Proficiency Level, as outlined, to allow them to be a Nipper.
Parent or Guardian Name*
First Last
Email*
Address
Address City State Post Code Country
Number or Children under 13 years*
- 1
- 2
- 3
- 4
Child 1 Name*
First Last
Child 1 Date of Birth*
DD slash MM slash YYYY
Child 2 Name*
First Last
Child 2 Date of Birth*
DD slash MM slash YYYY
Child 3 Name*
First Last
Child 3 Date of Birth*
DD slash MM slash YYYY
Child 4 Name*
First Last
Child 4 Date of Birth*
DD slash MM slash YYYY
It is vital for Surf Life Saving Clubs to ensure their enrolled Nippers are proficient in the pool and surf, to ensure they are: SURF COMPETENT, SURF CONFIDENT, SURF SAFE Each year your child/Children must successfully complete their Age Groups Proficiency Level, as outlined, to allow them to be a Nipper. This is a compulsory requirement for SLSA.
Parent/Guardian Agreement*
I agree to the Nipper proficiency levels agreement

JOINING MEMBERS FORMS – NIPPER FAMILIES

Step 1 of 3

New Member Proof of Age - Nippers and Parents.

Nipper Proficiency Levels Agreement

Volunteer Agreement

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