South Avon Canoe Club

Your Name:

Address:

Tel No:

E-mail:

Name of Leader:

Number in Group:

Number of Cars in group:

Event Fee @:

£3.00 per BCU Member:

£

£5:00 per Non BCU Member:

£

Camping Fee (Tents) @ £5:50 per person/night:

£    Fri    Sat

Total Amount Enclosed:

£

BCU Membership No/s:

Are You a member of South Avon Canoe Club?  If No please state NO.  If Yes please enter Club Membership No/s:

Emergency Contact Details:

Please provide details of someone who can be contacted in the event of an emergency:

Name:

Tel No:

Medical Conditions:

It is essential that you inform us of any medical condition e.g. asthma, diabetes, that may affect your ability in this sport.
(What you say will be treated in the strictest confidence).
Please enter any information in the box below.  If none please enter 'NONE'. DO NOT LEAVE THIS BOX BLANK.

I/We understand that all participants must be of a minimum 2 Star standard with moving water experience and that I/we must be properly equipped and led. I/We also agree that canoeing is a risk sport and that I/we take part at our own risk.  Due to the paddling distances involved, it is suggested that this event isnot suitable for young people below the age of 14.

(PARENT OR GUARDIAN, IF UNDER 18)

Please make all cheques payable to
"SOUTH AVON CANOE CLUB"
and send this completed, signed and dated booking form to: 

South Avon Canoe Club,
c/o Neil Fuller,
Sheran Cottage,
Saxon Street,
Lower Langford,
North Somerset.
BS40 5BP