Application Form
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• Police and Fire: 10111 • Medical: 10177 • From mobile: 112
It is important to know local emergency numbers for your own area as well. Memorise these and make sure your children know what to do and whom to call in an emergency as well.
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Application to attend a Child Safety Course
Applicant's Name:
Occupation:
Street Address:
Postal Address:
Employer/Employment Details:
Home phone:
Fax:
E-Mail:
Specify Training Course:
Date of Training:
Signed:
Date:
Conditions of registration:
Contact person: Please forward all completed application forms together with the deposit fee marked for the attention of:
Pumla Mtambeka
Childsafe PO Box 791, Rondebosch 7701 Tel: (021) 685 5208/ 658 5240 Cell: 083 696 3395 Fax: (021) 685 5331 E- mail: capfsa@pgwc.gov.za