Model Client Course - Single Rope Technique Endorsement Assessment

Please fill in the form below to 'Register your interest'. Ensure you meet all the requirements. If you have any concerns about medical conditions, injuries or your suitability to participate safely as a model client please email admin first before filling in this form.

'What the day may include' are guidelines only. What actually gets covered on the day will be determined by what the Assessor needs to see the candidates demonstrate. Their goal however, is to provide you with an educational, fun and safe day out.

Course ID:	4883	Name:	Single Rope Technique Endorsement Assessment
Start Date:	29-05-2027
Model Client Requirements:	Age 14yrs and above. Must be relatively comfortable at heights. No cave specific experience necessary, abseiling or rock climbing experience is an advantage. Hire fee for SRT kit (approx. $10), if not able to provide your own.
What the day might include:	1 day instruction on skills such as cave safety, equipment, ascending and descending techniques, abseiling.

Under 18 yr olds must be accompanied by an adult who is responsible for them and also participates as a model client. For Rock courses only, adults can choose not to participate but must stay onsite to supervise under 18’s.

An adult (18+) needs fill out this form. Please ensure YOUR name and contact details are listed first. You will then have the option to enter other participants (children & adults) if applicable.

First Name *

Last Name *

Attendance *

Email *

Mobile Phone / Best Contact No *

Travelling From *

Would you like to register for more than one person, a child (U18), or a group? *

No Yes

Name of Group / Family

If you are not attending and you are registering Under 18's, who is the accompanying Adult responsible on the day?

Accompanying Adult Contact Phone Number

How many in your group will be participating? (Include yourself/accompanying adult/s if participating)

List all participating group members (including yourself/accompanying adult/s if participating) and the age they will be at the start of the course. Please put age in brackets i.e. Sally Smith (14), Bob Smith (18+).
Group participants and age

Previous Experience (Provide details to show you/your group meet the model client requirements above e.g. previous experience and/or formal instruction. Group Coordinators - outline group experience range) *

Are you interested in carpooling? *

No Yes

Why are you interested in attending this course? *

Model Client Calendar