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Lifejacket Loan Scheme Request Form

Contact details
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This question requires a valid email address.
Please note: 
  • The lifejackets are in high demand. Please submit your request as early as possible. 
  • Hireage is subject to availability (dates and sizes). Maximum 30 lifejackets per user during peak periods and maximu, two-week rental, from pick up date to return date. 
  • If you are a Water Auckland school, you will collect and return your order from the Sport Waitakere Hub. (We will give you the directions). 
  • If you are unable to collect the lifejackets DPA can arrange a courier to collect your order (at your expense). 
  • Although the lifejackets are available free of charge, a koha will be greatfully received. This will help us expand the loan scheme programme.
    This can be paid via our bank account: 02-0108-0298232-00 (please include your name/organisation name and LLS as reference).  
Please indicate your requirements.
Total : 0
Please indicate collection and return dates (maximum two-week period).
This question requires a valid date format of MM/DD/YYYY.
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This question requires a valid date format of MM/DD/YYYY.
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Terms & Conditions

To ensure another school doesn't miss out, and in accordance with using lifejackets from Drowning Prevention Auckland (DPA), it is agreed that we (the User) will undertake the following: 
  • Record and provide evidence to DPA of the number lessons the lifejackets are used for, and the number of participants. Click here to submit your feedback online or request a feedback form from kushida.rasheed@dpanz.org.nz or phone 09 376 5114.
  • Return lifejackets on agreed date, rinsed, dry and zipped, with belts threaded and clipped, bagged by size.
  • This form must be completed and submitted to DPA prior to collecting your order.
User Statement: I / We have read and understood these Terms & Conditions.
This question requires a valid date format of MM/DD/YYYY.
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Signature
Clear
Signature of
Thank you, your lifejacket request has been submitted. Coordinator Kushida Rasheed will be in touch to confirm your booking. Please email kushida.rasheed@dpanz.org.nz or call 09 376 5114 if you have any questions.