Name

Address (Including Postcode)

Date of Birth (if under 18)

Telephone numbers :

Day

Night

Email

Sailing Experience (RYA levels incl Powerboat)

Medical or First Aid qualifications (if any)

Renewal Date

Medical Conditions the club should be aware of

Are you a boat owner No Yes

If yes, is your boat kept at the club? No Yes

If yes, is your boat a dinghy / keelboat / canoe / other? Dinghy Keel Canoe Other

Description of your boat:-

Class / make

Colour

Sail Number

Membership Kind Junior Single Family

Using e-mail is more cost effective, and less time-consuming for communications from the club. If you have an e-mail-address but would prefer to receive club mailings by post please select this option below

Post Email

I understand that the information on this form will be kept in electronic form and used by the club. Please select whether you will your details stored on a computer database solely for club use.

I disagree I agree