CAMBRIDGE CANOE CLUB by gdf57j

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									                                 CAMBRIDGE CANOE CLUB
                   MEMBERSHIP APPLICATION FOR THE YEAR ENDING 31ST MARCH 2010

Surname:                                                     First name:
Address:
                                                             Post code:
Tel (home):                                                  Tel (work):
Tel (mobile):                                                E-mail

Family membership: please enter details of other members on the back, giving name, date of birth (if under 18
years) and BCU qualifications as for first member.

If under 18, date of birth:                                  I can swim 50m in light clothing:        Yes / No

Membership fees: (Concessionary rates may be available)

Adult                                                        £50
Junior (U18) / Student (full time)                           £25                           Please circle fee paid
Family (2 adults and all juniors at same address)            £100

                                                    COACHING
  For details of canoeing courses available with Cambridge Canoe Club please contact the Coaching Officer:
                                 courses@cambridgecanoeclub.org.uk

Qualifications:
British Canoe Union:                                                       First Aid & Life Saving:
1-star (Kayak/Canoe) 2-star (Kayak/Canoe) 3-star (Kayak/Canoe)             First Aid:                    /       /
4-star (Inland/Sea/Canoe) [Proficiency]                                    Canoe Safety:                 /       /
5-star (Inland/Sea/Canoe) [Advanced Proficiency]                           RLSS Bronze                   /       /
Level 1 Coach/Training (Kayak/Canoe)                                       RLSS Award of Merit:          /       /
Level 2 Coach/Training (Kayak/Canoe)                                       RLSS Std. Resus:              /       /
Level 3 Coach/Training (Inland/Sea/Canoe)                                  RLSS Adv. Resus:              /       /

Other relevant qualifications:

Are you a BCU member?            Yes / No                    BCU number (if available)

Please pay by cheque, payable to Cambridge Canoe Club, and send with this form to:

                  CCC Membership, c/o Arthur Davis , 20 The Close , Babraham , Cambridge , CB22 3AQ

                              Email: membership@cambridgecanoeclub.org.uk

Please contact CCC Membership if you do not want your membership details to be kept on a computer.

Canoeing is an assumed risk sport; it is the responsibility of the participant (where appropriate, parent or
guardian) to make him- or herself aware of the risks involved and to take appropriate precautions.

Signed:                                                                    Date:

If the member is under 18 years of age, this form must be signed
                                                                           Parent / Guardian
by their parent or guardian, who should indicate his or her status:

The Newsletter is now available on the club website (www.cambridgecanoeclub.org.uk), but CCC will
continue to mail a copy to your home address by request:

I would like to receive a mailed copy of the CCC Newsletter                                      Please tick one box
I will download my own copy of the CCC Newsletter                                                       only

CCC Members Email group – I/we would like to join the email group                             Please tick if required
Additional Family Members:


Name


Date of Birth

BCU Membership Number
(if applicable)




Name


Date of Birth

BCU Membership Number
(if applicable)




Name


Date of Birth

BCU Membership Number
(if applicable)




Name


Date of Birth

BCU Membership Number
(if applicable)



(Please continue on a separate sheet if necessary)

								
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