MEMBERSHIP APPLICATION
Note: membership is subject to club committee approval and must be  supported by a current club member

Individual - $85

Family Membership - $130

Junior (under 18 at 1 June) - $50

Rack Fee (kayak storage)- $80

Associate Membership (non active) - $45

Name

Address

Phone (hm)

   Phone (wk)

Phone (mob)

EMail

Occupation


    I Can Assist the Club by

Event Marshal/Helper

Fundraising

Other (please specify)

Amount Enclosed:

DATE:

SIGNATURE:

Application Supported by (current  member)

Cheques payable to:

Waitemata Canoe & Multisport Club

Send to:

PO Box 83 037, Edmonton, Waitakere City