Yakity Yak Kayak Club Enrolment Form
We ask that all new and current club members please complete this form to ensure that we have everyone's complete and up-to-date information.
Also use this form to update any details such as change of address etc.
Given Name *
For a family membership, please give all members names.
Your answer
Last Name *
Your answer
Company
Your answer
Address1 *
Your answer
Address2
Your answer
City *
Your answer
Post Code *
Your answer
Phone Numbers *
Home, work, mobile as applicable
Your answer
Email Address *
Your answer
Emergency Contact Person 1 *
Name, Relationship, Contact Numbers - not the person you often paddle with.
Your answer
Emergency Contact Person 2
Name, Relationship, Contact Numbers
Your answer
Relevant Medical Conditions, and Medication *
Your answer
Club Affiliation *
Which Yakity Yak Kayak Club are you associated with?
Date You Completed Your Course
If you don't know the exact date, approximately date is fine.
Your answer
Are you a current active Trip Leader?
Anything else you would like to tell/ask us?
Your answer
Risk Disclosure Acknowledgement *
Required
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