Club Membership Registration Form

Club Membership Registration

Complete the form below to sign up to Ocean Blue Sports Club
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Other Information*

GenderEthnicity (used for statistics)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date*

DayMonthYear
Parent/Guardian Emergency Contact*

NamePhone Number
Health Concerns/Injuries - all responses are confidential
Membership Type

Junior $60Senior $120
Please provide a portrait photo for your ID Card *

Cancelof
Please provide a copy of your birth certificate or passport for verification*

Cancelof
MEMBERSHIP DECLARATION

1. The details set out in the Membership Form are true and correct. If they change, I acknowledge that I am required to notify my club (Ocean Blue Sports Club) of the changes, in writing, as soon as possible after they occur.

2. I will be bound by the constitutions, regulations, policies, manuals, guidelines and reasonable directions of my club (Ocean Blue Sports Club), AROCA, and NKOA respectively.

3. I have voluntarily accepted and assumed the inherent risk of danger and injury in waka ama paddling.

4. I will not hold my club (Ocean Blue Sports Club) or their respective officers responsible for any claims, losses and expenses which may arise from or in connection with my membership and/or participation in any activity authorised or recognised by my club, except in the case of gross negligence or a willful act or omission on the part of my club.

5. I indemnify my club from all claims, losses and expenses suffered or incurred at any time, occurring as a result of or resulting directly or indirectly from my failure to observe the constitutions, regulations, policies, manuals, guidelines and reasonable directions of my club (Ocean Blue Sports Club).

6. I am medically and physically fit and do not suffer from any disease or conditions, either physical or mental that would affect my ability to safely participate in any authorised or recognised activities of my club. If I am unsure about the declaration, or suffer from such a condition, I am aware that I must bring it to the attention of my club (Ocean Blue Sports Club).

7. I understand that my club (Ocean Blue Sports Club) will collect personal information about me for the purpose of:- Processing my membership
- Providing me with information and activities relating to my club
- My personal information will be held securely and will be made available upon request

8. I agree and understand that a fee is required per 6 months and as such entitles me to certain benefits provided by the club but does not allow for any decision making in the running of the club.

9. By paying such a fee I will continue to be a member of my club (Ocean Blue Sports Club), unless I resign or my membership is terminated.

10. Fees are payable to Ocean Blue Sports Club

Bank Account Details: 01-0215-0229814-00

11. As a member of Ocean Blue Sports Club, you will be affiliated to AROCA (Regional Body) and WANZ (National Body)

12. Copies of the constitution of the club (see website) and WANZ can be obtained via www.wakaama.co.nz
Member/Parent/Guardian Signature *

Clear
I have read, understood, and accepted the terms & rules for membership.
Should be Empty: