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Application for membership of eXsight Tandems Illawarra Inc
Registered charity, tax deductible for donations (ABN 44 664 198 133)

eXsight organises recreational activities for people with vision impairment or who otherwise cant ride a bike solo - primarily tandem cycling, and also acoustic target shooting.

MEMBER BENEFITS
Members have access to weekly organised tandem bicycle rides, and also to target shooting organised events.
Members benefit from the organisations' insurance cover while participating in events.

COSTS
Annual membership fee is a nominal $2, payable on first event with the group.
At each event members are asked to make a gold coin donation towards the running costs.

JOIN - complete the form below to become a member.

I would like to become a member of eXsight tandems Illawarrra Inc.
First name *
Surname *
Birth date *
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Address
Address Line 1 *
enter Street number and name
City or Suburb *
Post Code *
Contact details
email address
Home phone
please enter with area code and spaces eg 02 0000 0000
mobile
please enter with spaces eg 0000 000 000
Emergency Contact details
Emergency Contact
name of who to call in case of an emergency
Relationship
(husband, wife, partner, parent, child, neighbour, friend etc.)
Emergency Contact phone number
Involvement
What would you like to do with Exsight? *
If you are interested in more than one activity, use "other" and type in the activities. The Captain (or Pilot) is the front position on a tandem, and controls the bike, the Stoker is the rear position and pedals. Shooters are taken through training and are supervised by a suitably licensed shooter.
Nominating member
You need the agreement of an existing member of Exsight Tandems to be accepted as a member. Enter their name below.
Name of nominating member *
Any questions or comments?
Note it here and someone will get back to you.
Acknowledgement
I agree to be bound by the rules of eXsight Tandems Illawarra.

I also understand that cycling and other recreational sporting activities involve certain risks and by participating in organised events I do so at my own discretion.
I accept and agree to the conditions of membership *
After you check that you agree, please make sure you press the SUBMIT button on the completed form.
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