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My Emergency Contacts Entry Form

The purpose of this form is to enable club members to voluntarily list emergency contacts. When members are attending an event organised by the PCPP and, in the unlikely event that a serious medical event or injury arises, the event organiser will attempt to contact the Emergency Contact person. Please include at least one contact person.
Access to the emergency contact list will be restricted to authorised persons as per the MEMBER’S EMERGENCY CONTACT DETAILS Policy.

Please complete the form below

Your details:

Emergency Contact #1 details:

Emergency Contact #2 details:

Thanks for submitting!

Probus Club of Port Phillip Inc

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© Probus Club of Port Phillip Inc

 

ACN A0029363 Chartered: 25 March 1986 -  Incorporated 9 May 1994 

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