Next Level Surf Coaching Participation Declaration

Please ONLY complete this form if you have made a booking with Next Level Surf Coaching. If you have not yet booked in, you can BOOK IN HERE.

"*" indicates required fields

Step 1 of 8

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Please confirm the program you want to book?*

Is this your first time surfing with NLSC?*

Yes

Who referred you to Next Level Surf Coaching?*

Were your previous sessions with NLSC successful and what things did you take away from your last session?*

Is there anything in particular you would like to focus on during this up coming session?*

Please confirm location?*

Byron Bay

Bali

New Zealand

Hawaii

Other

Do require us to pick you up?*

Yes

What is your daily pick up address?*

For all half & full day bookings your surf coaching experience will commence each day at 08:00am unless otherwise stated. Please inform us of an address/ accommodation option you would like to be collected from each day.

What level of surfer do you consider yourself?*

Beginner

Novice

Intermediate

Advanced

Elite

How long have you been surfing for?*

I have never surfed

Under a year

1-2 years

3-5 years

6-10 years

Over 10 years

What's your stance?*

Natural Footer

Goofy Footer

I don't know

What type of surfboard do you regularly surf?*

Longboard / Log

Mini Mal / Mid length / Fun board

Short Board / High performance

Retro / Fish

Soft Board / Beginner foamy

None of the above

What’s the size and dimensions of your surf board?*

Do you think this surfboard is appropriate for your current level of surfing?*

Yes

Why not?*

Please describe your local beach / conditions / waves you regularly surf?*

The more information we have on your overall life, health & well-being the better we can tailor a coaching experience to best support your surfing.

What's your occupation?*

How would you rate your fitness on a scale from 1 (terrible) to 10 (elite)?*

Please enter a number from 1 to 10.

What would your average week of fitness look like (other than surfing)?*

Over the past 6 months how often would you say you’ve surfed?*

Everyday

3-5 days a week

Once/ twice a week

Once/ twice a fortnight

Only a couple of times a month

This will be my first time surfing in over 6 months

What do you want to gain from your coaching experience with Next Level Surf Coaching (long & short term goals)?*

Is there anything else we should know about your surfing before you arrive?

Due to COVID we do not supply wetsuits or swim wear. Please contact us if you need further assistance on any equipment issues?

What's your T-shirt size?*

Participant's Name*

First Last

Age

Please enter a number from 5 to 100.

Age must be supplied if participant is under 18 years old.

Phone Number*

Email*

Where the participant is under 18 years of age this form must be signed by the participant’s parent or legal guardian.

I am the parent or guardian of the applicant. I expressly agree to be responsible for the applicant’s behaviour and agree to personally accept the conditions set out in this application.

Address

Street Address Suburb State Postcode Country

Medical Information

(Confidential) Please indicate any medical conditions that instructors should be aware of.
Upon arrival, please ensure you inform your surf coach of any important medical information or relevant conditions. Please note, this will be kept completely confidential and is required only from our duty of care perspective.

Lesson Date:*

DD slash MM slash YYYY

Please select the date of the session (or start date of the program) you have booked with Next Level Surf Coaching.

How did you hear about us please?

Brochure

Vehicle

Accommodation

Online Search

Referral

Yellow Pages

Surfing NSW

Local Area Map

Surf Shop

Other

Surf Shop Name:

Are you on holiday in Byron Bay?

Yes

Where are you staying?

Consent & Agreement*

I have read, understood, acknowledge and agree to the above declaration including the warning, release and indemnity.

Next Level Surf Coaching's surfing programs can cover not only the technical skills of surfing but may also include other information and training, depending on the programs, such as first aid, oceanography and opportunities in the surfing industry to enable an ongoing involvement in a surfing lifestyle. The national certificate program, recognised and supported by the Australian Sports Commission is delivered by qualified Surfing Australia instructors. Soft surfboards, rash shirts and wetsuits (where necessary) are provided.

In consideration of Next Level Surf Coaching accepting my application to participate in the Program, below I acknowledge, understand and agree that:

1. "Surf School" for the purposes of this declaration means and includes Next Level Surf Coaching, Surfing Australia Inc ("SA"), SA affiliated state surfing associations, and their respective directors, officers, members, servants or agents.

2. Warning: Participating in the Program can be inherently dangerous. I understand the nature and requirements of the Program and acknowledge that serious accidents can and often do happen which may result in me being seriously injured or even killed. I have voluntarily read and understood this warning and accept and assume the inherent risks in participating in the Program.

3. Physical Fitness: I must not participate in the Program if I have any injury, disability, medical or health condition that may increase the risk of me becoming injured unless I have told the Surf School about it and they have authorised me to participate. I declare that I am medically and physically fit and able to participate in the Program and I will immediately notify the Surf School of any change to my fitness and ability to participate.

4. Instructions: I will at all times comply with the instructions and safety procedures of the Surf School.

5. Medical Treatment: If required, the Surf School will arrange medical or hospital treatment (including ambulance transportation) for me. I authorise such actions being taken by the Surf School and agree to meet all costs associated with such action.

6. Release & Indemnity: My participation in the Program is entirely at my own risk and I agree to:
(a) release and forever discharge the Surf School from all liability and Claims that I may have or may have had but for this release arising from or in connection with my participation in the Program;
(b) indemnify and hold harmless the Surf School to the extent permitted by law in respect of any Claim by any person including but not only another participant in the Program arising as a result of or in connection with my participation in the Program.
In this clause 6 “Claims” means and includes any action, suit, proceeding, claim, demand, damage, penalty, cost or expense however arising (including negligence, trespass to the person or for breach of implied terms in the sale of services under section 60 and 61 of the Australian Competition and Consumer Act (2010) Cth and equivalent provisions contained in State sale of goods or fair trading legislation).

7. Identity: Photographic and or visual images taken by the Surf School of my participation in the Program may be used for general promotion of the Organiser's activities

8. Privacy: I understand that the information provided by me in this form is necessary for the operation of the Program. I acknowledge and agree that the information will only be used for the objects of the Surf School and to provide me with information pertaining to the Program. I understand that I will be able to access my information through the Surf School upon request. If the information is not provided I might not be permitted to participate in the Program. The completion of your email address enables us to email you various information throughout the year. If you do not want to receive email from Next Level Surf Coaching, please do not fill in your email address or you can reply Unsubscribe to the emails and you will be removed from our list.

Signature*

The safe surfing program covers not only the technical skills of surfing but areas such as first aid, oceanography and opportunities in the surfing industry to enable an ongoing involvement in a surfing lifestyle. The national certificate program, recognised and supported by the Australian Sports Commission is delivered by qualified Surfing Australia instructors. Soft surfboards, rash shirts and wetsuits (where necessary) are provided.

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