Membership Application

external page used for Membership Application form (hidden – do not delete)

Please leave the page title untouched – this is included in the header of this page, and this page uses a customised template which only outputs the HTML header of this page, including navigation, which the new-member script scrapes and injects as the header of the new member script HTML (thus ensuring that any changes to the site menu are reflected in the external script output).

Text like this in the body of the page is not output at all, hence we can leave a helpful notice like this for anyone driving past to understand what is going on here.

MEMBERSHIP APPLICATION

A copy of this membership application will be emailed to you after you submit the form

Upload your 3 completed visitor walk records here*:

(20 Mb total filesize permitted, max 3 files - doc, docx, rtf, pdf, txt, zip archives and image files only)

Your details

I hereby apply for membership of the Sunshine Coast Bushwalking Club and supply the following personal details:

First name*

Last name*

Email*

Street address*:

City*:

State*:

Postcode*:

Country*:

Phone: Home

Phone: Work

Mobile*:

Date of birth*:

Select Date

Occupation:

Current first aid certificate, date renewed:

List of Medical Conditions and/or Physical Disabilities:

List of Allergies:

Emergency contact

First name*:

Last name*:

Mobile phone*:

Your 3 Guest Walks that qualify you for membership:

Walk 1 Location*:

Walk 1 date*:

Walk 1 Leader Name*:

Walk 2 Location*:

Walk 2 date*:

Walk 2 Leader Name*:

Walk 3 Location*:

Walk 3 date*:

Walk 3 Leader Name*:

ACKNOWLEDGEMENT OF RISKS AND OBLIGATIONS OF MEMBERS and PROSPECTIVE MEMBERS

This acknowledgement of risks applies to all club activities I may undertake as a member or prospective member of The Sunshine Coast Bushwalking Club (The Club). In participating in activities of the Club which are described to me by the activity leaders. I am aware that my participation in the activities may expose me to hazards and risks that could lead to injury, illness, or death or to loss of or damage to my property. I also acknowledge that I may encounter weather conditions that could lead to hypothermia and being in locations where evacuation for medical treatment may take hours or days.

In particular, when participating in abseiling or above the snowline activities I am aware that these activities could expose me to additional hazards and risks described to me by the activity leader.

To minimise risks I will endeavour to ensure that:

Each activity is within my capabilities
I am carrying food, water, medication, and equipment appropriate for the activity
I will advise the activity leader if I am taking any medication or have any physical or other limitation that might affect my participation in the activity
I will make every effort to remain with the rest of the party during the activity
I will advise the leader of any concerns I am having, and
I will comply with all reasonable instructions of club officers and the activity leader.

I have read and understand the above requirements. I have considered the risks before choosing to accept this acknowledgement of risk. I still wish to join the activities of the club. I acknowledge that I will take responsibility for my own actions.*

I am aware of the aims of the Club and agree to abide by its Constitution and rules. I acknowledge that the payment of my membership subscription will be deemed as full acceptance of the Acknowledgement of Risks and Obligations of members and prospective members.*