Member Form – Hurricane Paddling Crew

Membership Form

Prefix

First Name *

Middle Name

Last Name *

AOCRA Number & Expiry *

Home Address *

Email Address *

Phone Number *

Date of Birth *

Gender *

Next of Kin *

Relationship *

Are you a Competent Swimmer? *

Note: To meet AOCRA safety requirements, each club is required to ensure member swimming competency through certification or testing

Do you suffer from any medical conditions? *

MessagePlease discuss it with the club’s head coach and team manager and please list all medical conditions and all pre-existing conditions and injuries such as asthma, heart condition, blood pressure, diabetes, etc.0 / 180

Do you have a current WA jet ski or boating licence? *

Are you a Level 1 Outrigger Coach? *

What is your Certificate Number? *

Occupation *

Are you transferring from another AOCRA Club? *

Previous Club *

Joined memberships? *

Boat storage request? *

Membership Type *

Credit / Debit Card *

DECLARATION *I certify that all information on this form is correct at the time of completion. I agree to become a full member of Hurricane Paddling Crew and to be bound by the Constitution, By-laws, Rules & Articles.

PARENT LEGAL GUARDIAN CONSENTI agree to my child becoming a member of Hurricane Paddling Crew(if under 18)

Please provide parental or guardian name and phone number *

MEDIA RELEASE *I hereby authorise Hurricane Paddling Crew to use my/my child’s photos, videos and other media type in any promotional activites engaged in by Hurricane Paddling Crew. This includes our social media and website.

Upload Paddler Signature *

No file chosen

Date *

Name

Membership Form

Note: To meet AOCRA safety requirements, each club is required to ensure member swimming competency through certification or testing

Want to Be Part of Our Club?

Club Contacts

Membership Form

Note: To meet AOCRA safety requirements, each club is required to ensure member swimming competency through certification or testing

Want to Be Part of Our Club?

Club Contacts

Let's Connect