You can either fill in this form on-screen and print it, or print it and fill it in by hand, but
the parental signature for under-18s must be handwritten!

Full Name of Participant
Date of Birth (under 18s)		Age
Address
Contact Telephone Numbers: Home  Mobile    Work
Email Address
Any coaching awards or star tests
Slalom Paddlers please list:
Class (K1M, K1W, C1, C2)   Division WCA/BCU Membership No
Membership Fee Paid (please tick one)
Adult Full Member £20    Adult non-paddler £10    Junior Under 18 Years Old £10    Student or Unemployed £10    Family Membership £45

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PARENTAL CONSENT FORM FOR ALL MEMBERS UNDER 18 YEARS OLD

I give permission for (Name/s)

To become a member of Llandysul Paddlers Canoe Club and I accept that Llandysul Paddlers Canoe Club will not be held responsible for any loss of equipment or any injury incurred during training sessions or any other event held in its name.

I also give permission for my child to take part in any activity organised by the club and to go on any organised trips and to travel in the canoe centre mini bus. In the event of an accident I give permission to any committee member of the club or any responsible adult, to get any medical attention needed.

Signed.....................................................................................(Parent/Guardian)