Marine SafetyWorks

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Safety & Sea Survival Course - Register of Expressions of Interest

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Are you attending this event?

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First name*

Last name*

Phone number*

Email address*

Address*

Current Email Address*

Current Mobile Phone Number*

Current Address

Any comments or specific requests Max. 255 characters

In undertaking practical drills run by Marine SafetyWorks, I acknowledge that:

I attend the activity entirely at my own risk and must exercise due care to ensure my personal safety and that of others
I must follow any directions or advice affecting my safety given to me by the instructor or instructors
I will conduct myself in a safe and responsible manner for the duration fo the time that I am in the course sessions or on course premises
I will not interfere with any property belonging to another person without being given express permission to do so by a person authorised to do so
I understand that Marine SafetyWorks will indemnify me for injury only when proven liable by law
I will abide by all rules as set down by Marine SafetyWorks for the course

I confirm that I have read the above Event Waiver in its entirety.*

I agree to the Event Waiver.*

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*