Membership form
Prior to completing this form we recommend you attend a pool session or speak to a member of the committee - president@kayaknorthumbria.com
Full name *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Student term time address
Please leave blank if you are not a student
Your answer
Home address *
For students, this will be your parent's address
Your answer
Contact number *
Your answer
Email address *
Your answer
Medical conditions or allergies
Your answer
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