- Membership Form

Please complete the details below (legibly please, especially e-mail addresses… type it if possible), sign the form and send it together with a cheque made payable to Regents Canoe Club to:

Caroline Robson, 99 Innes Gardens, London, SW15 3AE

If you have any questions, please send an email to membership@regentscanoeclub.co.uk

Name
Address
Phone	Email
Phone (2) [*]	Email (2) ^*
Phone (3) ^*	Email (3) ^*
Person to contact in case of emergency:	Name
Phone	Phone (2)^*

Are you a member of BCU?

Yes

No

Membership Type

Full (see price below)

Associate (£15)

Concessions (50% discount for students/unwaged)

Amount Paid

The membership year runs from 1^st June to 31^st May. The full year membership is £48, but if new members join after August the cost decreases as below (the dates indicate the start of membership):

1^st June - 30^th August £48 1^st September - 30^th November £36

1^st December - 28^th February £24 1^st March - 31^st May £12

Full membership entitles you to paddle on the canal, hire equipment, receive newsletters, and go on club trips. Associate membership is only really intended for members who have moved away and wish to stay in touch with the club - they cannot paddle on the canal or hire equipment. Any persons living inside the M25 wishing to join only as associate members should apply to be considered on an individual basis by the committee.

Do you have any qualifications/experience (incl. coaching, first aid, canoe safety test etc)? Please detail incl. expiry date.

Private details

Your private details will be stored electronically for internal club use, and will always be kept as private as possible. On some occasions, however, your email address and phone number may be shared with other club members:

· The club maintains a mailing list to allow easy communication between members; your email address may be visible by other members on that list.

· Occasionally (for instance to help organising trips) your email address and/or phone number may be shared with other club members.

I agree to share my email address and phone number with other club members

I agree to share only my email address

I do not want to share any of my details

(note: this last option is not recommended as you may miss out on some club events or activities)

Newsletter

How would you like to receive the club’s newsletter?

By email, as an attachment

By email, as a link to the website

By post

How did you hear about Regents?

Limitation of Club Liability

As a member of the club, you (and your guests or visitors) may use club premises, facilities and equipment entirely at your own risk and implicitly accept that:

· the club is not liable for any damage to or loss of your property;

· canoeing and kayaking can be hazardous activities, and are undertaken at your own risk;

· open water in the UK, including Regents canal, may present a risk of Weil’s Disease (see below).

Declarations:

· I am over 18;

· I can swim 50m in light clothing;

· I agree to participate in the club duty rota as required (typically twice a year, for full members only);

· I have read and understood the information on Leptospirosis (Weil’s Disease) displayed on the club notice board or accessible through the club website, and accept the risks;

· I agree to read and observe the club’s safety policy displayed on the notice board;

· I understand the disclaimer above, and I agree to use the club facilities and participate in club activities at my own risk;

· I do not object to these records being stored on computer for internal club use.

Signature

Date

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[*] Optional…