Basic Skills 1 application form
Basic Skills 1 certificate application formlivepage.apple.com
The final two sessions will be held on Saturday 21 January 2012 and Saturday 19 February 2012 form 09:00 am to 3:00 pm at the LBT workshop, Huon Highway, Franklin.
Personal details
These details will be entered on to the Yachting Australia national database so you can progress to develop your skills in sailing anywhere in Australia by joining a member yacht club.
Name ...............................................................................................................
Street/PO ........................................................................................................................
Suburb ......................................................Postcode .......................
Telephone ................................ Mobile .............................................
email address ................................................................................................
Date of birth ........................ Medical conditions .........................................................
Allergies ........................................... Medications .......................................................
Parents/Guardians details
Name .................................................. Relationship.......................................................
Address (if different)........................................................................................................
Phone .............................. Mobile ............................... email ..........................................
I give permission for my child ....................................................... to attend the On the Water Program.
Signed ................................................................ Date ....................................
To make the payment of $25 for logbook and national registration with Yachting Australia
Print this form and post with a cheque for $25 to:
PO Box 79, Franklin, Tasmania 7113
or save as a pdf and send to coord@lbt.org.au
Make Internet Banking Payment to:
Bank…….CBA
Branch ….Huonville, TAS 7008
A/c name…The Living Boat Trust
BSB 06 7008
A/c no. 28031138
Please make sure you put your name as part of the “Reference” and it would assist the Treasurer if you could notify her by email that a remittance has been made:
Contact:
Chris Wilson
62978338
0488 978 338
Peter Laidlaw
62663266