Sunday 26 November 2017 at John Charles Centre

NATIONAL CLUB

SIMULATED EMERGENCY RESPONSE
CHAMPIONSHIPS

Sunday 26 November 2017 at John Charles Centre

for Sport, Leeds

Start time approximately 4.30 pm

The RLSS UK National Club Simulated Emergency Response Championship (SERC) event is open to all RLSS UK affiliated organisations.

Each affiliated organisation is entitled to nominate teams for the Championship. The maximum number of teams per club will be at the discretion of the organisers, and will depend on the number of entries.

A team consists of four members of either the same or mixed gender. Teams can be entered into the Junior or Senior competition, and all team members must meet with the age requirements on the day of the Championships. All team members must be members of the affiliated organisation and must be in individual membership of RLSS UK at the time of entry and on the day of competition (and in possession of their membership card or MyApp).

Junior section

All team members must be between the age of 14 and 17 years on the date of the Championships.

Senior section

All team members must be 17 years or over on the date of the Championships.

Subjects and Marshals

A requirement for entry into the SERC is that each team entering must provide one individual member to act as a subject and one individual member aged 16 years or over to act as a marshal throughout the event. No exceptions can be made.

Subjects and Marshals

A requirement for entry into the SERC is that each team entering must provide one individual member to act as a subject and one individual member aged 16 years or over to act as a marshal throughout the event. No exceptions can be made.

Entries

Please send your notification of entry and entry fee of £40.00 per team to RLSS UK HQ by 5 November 2017. Credit/Debit Card payments may be made before submitting entries. Please call 03003 230096 and ask for Finance Dept. Or email

Late entries will be accepted up to 12.00pm on the day of the event. The late entry fee is £60.00 per team, and all team members are required to produce their RLSS UK membership cards /MyApp as proof of current memberships.

The draw for the SERC Championships will take place at 12.30pm on the day of the event.

Please also see the RLSS UK National Club Simulated Emergency Response Championship Rules 2017 available as a separate document at www.rlss.org.uk

ENTRY FORM

Sunday 26 November 2017 at John Charles Centre

for Sport, Leeds

Start time approximately 4.30 pm

Name of organisation affiliated to RLSS UK:

RLSS UK Society number of affiliated organisation:

Expiry Date of affiliated organisation:

(Number of) teams into the Junior section @ £40 per team

(Number of) teams into the Senior section @ £40 per team

Please tick as appropriate:

☐We enclose a cheque made payable to RLSS UK for £ as entry into the National SERC Championships.

☐We have already made a payment of £ to Finance dept. at RLSS UK HQ (03003 230096).

Contact details:

Name
Address
Daytime Phone No.
Email
Signed
Print Name

Notification of Marshal

Sunday 26 November 2017 at John Charles Centre for Sport, Leeds

Start time approximately 4.30 pm

At least one person over 16 years of age per Club must be available for marshalling duties for the duration of the Championships.

Marshal Contact details:

Name
Address
Daytime Phone No.
Evening Phone No.
Email

Alternative / Additional Marshal Contact details:

Name
Address
Daytime Phone No.
Evening Phone No.
Email

Notification of Subject

Saturday 26 November 2017 at John Charles Centre for Sport, Leeds

Start time approximately 4.30pm

Please tick the type of Subject(s) you are willing to be - as many as possible please.

Please also read up on the various subjects you are prepared to be. This information is available in the Survive & Save candidate manuals, the Lifesaving Manual for Instructors, or is available upon request from RLSS UK.

Wet (in the Water) / Please tick if relevant
Unconscious
Panicking
Non panicking

Subject Contact details:

Name
RLSS UK Society No.
Daytime Phone No.
Evening Phone No.
Address
Date of Birth / Approx Weight
Signed / Dated
Age at competition if under 16
Parent’s Signature if subject is under 16
Email

Please return this form by 5th November2017 to , or RLSS UK, Red Hill House ,227 London Road, Worcester ,WR5 3JG

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