Membership and Consent Form
Please print and complete one form per person

Name______________________________________Phone:___________________________

Address_____________________________________________________________________

Email_____________________________________________@________________________

BCU Membership no (If applicable):_______________________________

Complete ONE of the following

ADULT: I _________________________wish to take part in organised paddling activities (Kayak and/or Canoe) and I agree to abide by the rules and regulations of Totnes Canoe Club (TCC) as layed out in the TCC Operating and Safety Policies.

JUNIOR (<18): I am the parent or legal guardian of ______________________________ and I give consent for them to take part in organised paddling activities (Kayak and/or Canoe) and I agree they will abide by the rules and regulations of Totnes Canoe Club (TCC) as layed out in the TCC Operating and Safety Policies.

Activities

I am aware that participation in paddlesport carries a risk to personal safety, and that the club offers two types of activity, and I have indicated below (circle one per row) which ones I / my child may engage in:

A). Training courses led by a BCU qualified leader	YES / NO
B). Recreational activities with no leader, paddling as a group of peers	YES / NO

Conditions

• I accept that I am responsible for determining whether any activity is of a suitable type.
• I consent to emergency medical treatment arising from any incident, including the administration of an anaesthetic if required.
• I do not / my child does not suffer from any medical condition relevant to safety while engaging in paddlesports. (Note: please consult your GP if in any doubt about the relevance of any condition.)
• I undertake to inform leaders or members of the group of any relevant conditions.
• I confirm that I / my child can swim 50m in light clothing.

I consent to my personal details as recorded above being stored on computer or on any other medium to be used for Totnes Canoe Club business only. (Your rights under the Data Protection Act are not affected.)
By supplying an e-mail address you will be included on the Club email mailing list to be notified of Club Trips, Peer Trips and club events. The Club email list will only be used by Club Committee Officers for the purposes of informing members of paddling activities. You can request for your details to be removed at any time.

Signed_______________________________________ Date_________________________