K.S.A MEMBERSHIP FORM
1st March 2021- 28th February 2022
Name: ......................................................
Address: .......................................................
....................................................... ....................................................... ..........................................................
Post Code: ............................................
Telephone: ...........................................
E-Mail : ..................................................................
Car Registration No(s): .........................................
Please choose type of membership required..................................
Family/Single - (£110) Group - (£220), Unwaged - (£25)
There is a one-off Joining Fee – (£40)
Please indicate any craft you have: …………………………………………………………………..............................................................................
Please indicate numbers in your membership..........................................................................................................................................................
Do you need to store craft at the lake? (Cages cost £120 each, berths £60 each and racks £30 each)
Declaration by Member:
I am competent to handle the craft registered
I consent to the rules of the Association and agree to abide by them (Copies of the rules are available on request)
I understand that all users of the lake take full responsibility for their own safety
I am over 18 years of age (or, if under 18, will only use the lake under the supervision of a responsible adult)
I hold valid insurance which covers '3rd party' claims up to at least £1 million against any person authorized by me to
sail a craft I have registered on the reservoir (Please note members do NOT require insurance to sail the club craft as
they are covered by the Association's insurance)
I am happy to undertake routine duties to help run the club
I agree to this information being stored on a computer
Signed ........................................................................... Date .....................................................
Please highlight+copy and complete the form and email it to the Membership Secretary at mylesripley@btinternet,com