FAIRHAVEN SLSC

Summer Nipper Program

27 December 2026 to 4 January 2027

Nipper name

Child Name*

Date of Birth*

Gender*

Male
Female

Age group*

Fairhaven SLSC Membership number*

I confirm nipper is a paid financial member of FSLSC*

Swim proficiency form upload*

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Allergies or specific health issues

Check if first time nipper at FSLSC?

PLEASE NOTE: Application will not be accepted without valid FSLSC membership (ie correct number) and completed swim proficiency form.

Primary parent contact

Name*

Email*

Phone Number*

Secondary contact

Name*

Email*

Phone Number*

Compulsory family volunteer role

Every family must volunteer for at least one role. To be clear if you have 3 children only 1 volunteer role is required. You are more than welcome for both parents to volunteer.

FULL DESCRIPTION OF ROLES ON WEBSITE UNDER NIPPER SECTION

Name of volunteer*

Where would you like to volunteer?*

Preference notes

If volunteering for another child please specify child name and age group

I confirm I am able to fulfill the role I have signed up for*

Interested in competing for Fairhaven SLSC?

Interested in competing for Fairhaven in the following carnivals:*

Ocean Grove - Saturday 5 Dec 26
Torquay - Thursday, 7 Jan 27
Mt Martha - Sunday, 17 Jan 27
Mordialloc - Sunday, 31 Jan 27
Lorne - Saturday, 20 Feb 27
State Champs - Moordialloc, 6-8 March 27

Almost done. Where should we send the confirmation?

Email*

Name*

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