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NEW MEMBER - CLUB PADDLER REGISTRATION

REGISTRATION FEES

Senior Membership - $70

Junior membership - $45

Member Details, Contact information
Zone:
Club:
Surname:
Given name:
Password:
Date of birth
 /  / 
Gender
Male Female
Address:
Town
State:
Post Code:
Tele Home:
Tele Work:
e-Mail:
Mobile:
Next of Kin Name:
Relationship:
Address:
Telephone:
Additional data, important to your membership
Are you a Competent Swimmer ?

(NOTE: TO MEET AOCRA SAFETY REQUIREMENTS, EACH CLUB WILL ENSURE
YOU MEET MEMBER SWIMMING COMPETENCY, THROUGH CERTIFICATION OR TESTING)

Do you have a medical condition that could impact your safety or the safety of others when training or racing Outrigger Canoes?
Do you subscribe to State/Territory Ambulance Service?
If Yes, Please identify which State?
Are you a Member of a private health care fund?
Do you agree for your details to be used for publication?
Are you an Outrigger Level 1 Specific Coach
INDEMNITY & RELEASE
Declaration on behalf of a junior person- under 18

 I hereby acknowledge that I have read and consent to being bound by the AOCRA Indemnity Agreement and abide by the Rules, Directions and Constitution of AOCRA INC and the club and to accept the terms, exclusions, conditions and limitations of V-Insurance Group Injury and Legal Liability Insurance Contract. I have read and understand the AOCRA Anti-Doping Policy as published at www.aocra.com.au

 By accepting the terms and conditions set out herein you further authorise V-Insurance Group to on forward information relating to any incident and/or claim to AOCRA