Membership Form

Name:

Home Address:

Postal Address:

 

 

Telephone:

Mobile:

Email:

Emergency Contact

Name:

Contact Address:

Telephone:

Mobile:

Relationship:

 I have a First Aid Certificate

 I do not wish my image to appear in any photograph on the Club's Website

Acknowledgement of Risks and Obligations of Members
This acknowledgement of risks applies to all club activities I may undertake as a member of the Tablelands Walking Club Inc (The Club). In voluntarily
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.

To minimise risks I will endeavour to ensure that

  1. 1. Each activity is within my capabilities.

  2. 2. I am carrying food, water and equipment appropriate for the activity.

  3. 3. 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.

  4. 4. I will make every effort to remain with the rest of the party during the activity

  5. 5. I will advise the leader of any concerns I am having, and

  6. 6. 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 sign 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 and that signing this form and the payment of my
subscription will be deemed as full acceptance and understanding of the above conditions.