Online Membership Form 2017

INNY KAYAKING ASSOCIATION MEMBERSHIP FORM
Year of Membership 2017 (valid for the period January – December 2017)

CLUB SAFETY STATEMENT

  1. Never canoe alone!
  2. Do not canoe if you cannot swim!
  3. Always wear adequate buoyancy & helmet and ensure there is adequate buoyancy in your boat!
Personal Details
Plese, enter your personal details.
Enter your full name.
Enter your date of birth.
Enter your postal address.
(+353)0
Enter your telephone number.
Enter your e-mail address.
Membership Options
Please, select your membership details.
Irish Canoe Union Membership. This is optional and is not included in club membership.
As per key policy in member's manual.
Other Details
Are there any physical or other condition(s) that the Inny Kayak Association should be made aware of? If yes please give details.
Do you have any previous Canoeing/Kayaking or water sports experience?
Do you have any Canoe or Kayak proficiency awards? if yes, please specify.
Do you own your own kayaking equipment? If yes please list e.g. full set of equipment
As the club has its own website can pictures of you kayaking be placed on this website and social media websites.
INDEMNITY STATEMENT

I, in consideration of being admitted to the Inny Kayaking Association and allowed to participate in all of the Associations outings between 1st Jan to 31st Dec 2017 and use equipment provided by or on behalf of the Association, hereby undertake to indemnify the Association against all liability of any kind to myself or to other persons in respect of death or injury (including that due to neglect or fault of the Club, its members, servants or agents) suffered by me as a result of participating in Associations outings , and I declare that this indemnity shall (in the case of my death) be a continuing one binding on my legal person, personal representatives and my estate generally. I confirm that I can swim at least twenty-five meters and am proficient at treading water. I have read the Club’s safety statement and I agree to abide by it along with the other rules and regulations contained in the Members Manual and Club Constitution. I assent to abide by the Irish Canoe Union Child Protection Policy and as such agree to fully adhere to the principles and responsibilities embodied in the Irish Canoe Union Code of Conduct for the Protection of Children.

The club committee reserves the right to refuse membership or in certain circumstances terminate membership.

Select, to sign the indemnity statement.
Membership is subject to ratification by the Committee
Completed forms & associated fees should be sent to the Treasurer before Feb 1st 2017.
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