ABERDEEN KAYAK CLUB

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					ABERDEEN KAYAK CLUB                                      Membership Application Form

Please list below the names of all persons for whom membership is being sought, giving the date of
birth of Youth membership applicants (i.e. those who were under 18 at the beginning of this year)


!  Please read the section “ATTENTION ! “ on page 2 and then put a tick in this column to indicate those prospective
members for whom you have submitted additional information on page 2

Subscriptions: FULL member £25 YOUTH member £10                FAMILY: Additional Adult £12.50            Additional Youth £5
                                                                                              Date of Birth if      Subscription
                                       FORENAME & SURNAME                              !      Youth member          Enclosed
FULL or YOUTH Member
(For family memberships this must be                                                                                £
a FULL member)

Additional Family Member                                                                                            £

Additional Family Member                                                                                            £

Additional Family Member                                                                                            £

Additional Family Member                                                                                            £

Additional Family Member                                                                                            £


         TOTAL MEMBERSHIP SUBSCRIPTION ENCLOSED          (Cheques/ P.O.s payable to Aberdeen Kayak Club)            £

Member’s contact details (for Family memberships this must be for the Full Member)
Address                                                       Home Tel:

                                                              Work Tel:

                                                              Mobile Tel:

Post Code                                                     e-mail addr.



APPLICANT’S DECLARATION To be signed by the prospective FULL or YOUTH member.
I agree to abide by the Rules and Regulations that may be drawn up from time-to-time in the management of Aberdeen
Kayak Club and its activities. In applying for membership of Aberdeen kayak Club I am aware of the responsibility
being undertaken as a participant in Outdoor Adventure Activity Sports and do hereby confirm the ability of ALL
THOSE LISTED ABOVE to swim 50 metres unaided.


Signed ……………………………..……………                                                 Date …………….………….
                          Don’t forget page 2

    Please return the completed form and payment to the Club Treasurer. (no cash by post please)

PARENT / GUARDIAN APPROVAL                        To be completed if any applicant was under 18 at the beginning of this year.

I am the parent / guardian of the above Youth membership applicants and I am aware of the nature of the activities
involved and of the voluntary nature of the Club Management. I hereby give my approval for the applicants to join
Aberdeen Kayak Club.

NAME OF PARENT/GUARDIAN…………………………………………………………..………………..


Signed by Parent/Guardian……………..……….………                                      Date ……………………….
ATTENTION !
Do any of the prospective members listed above, suffer from any medical or physical condition that may require special
attention during Club sessions? In particular we need to be aware of such conditions as Asthma, Diabetes, Epilepsy etc.
and of any known food or medical allergies such as Nuts, Flour, Insect stings etc.

                                                        YES / NO
If you have answered yes, please complete a separate section of form (AKCM2) for each prospective member to whom it
applies and put a tick against their name in the column headed ! in the list of applicants on page 1.

Aberdeen Kayak Club reserves the right to seek further medical advice from qualified practitioners prior to accepting
membership applications, and to refuse membership to applicants who may pose an unacceptable risk to themselves or
other members of the Club.

EMERGENCY CONTACT       If you wish the club to contact a particular person in the unlikely event of an accident or emergency, please
                        provide their contact details here.

NAME                                                                   Relationship
ADDRESS                                                                Telephone Numbers




A bit about yourself
Have you canoed before?           Yes / No

Are you a member of the Scottish Canoe Association or British Canoe Union? (Membership No……………)

What kinds of canoeing appeal to you?               (Delete any that don’t, add any we’ve missed)

        Gentle recreational paddling on: rivers / lochs / sea
        Moderate grade rivers / Big White Water / Serious Surfing / Playboating
        Touring / Expeditions: on inland waters / at sea
        Competition: slalom / polo / white water racing / sprint / marathon / surfing / freestyle

What, if any, of the following do you own?

Canoe (type………………………..……………………) / paddle / spray-deck / buoyancy aid / crash-hat

Do you have transport that you are willing to use for Club meetings?          Yes / No
If yes, is it fitted with any of the following? Roof-bars / Uprights / Tow-ball

If you have canoed before:
        When did you first paddle?…………………….. and last …………………….paddle?

        What level do you think you achieved?                Beginner / Intermediate / Expert

        Please tell us of any level of achievement awards that you have (e.g. BCU star awards)

        ………………………………………………………………………………………………………………..

        and of any BCU or SCA coaching awards …………………………………….………………………..

        If you have previously been a member of another canoeing club or centre, what was it?

        ……………………………………………………………………………………………………………….

                                   Have you filled in all the details on page 1?

				
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posted:2/28/2010
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