Registration form Wageningen
Kayak and Canoe Club "De Bovenste Polder"
Please address to :
WKV De Bovenste Polder
Wim Sonneveldstraat 10
6708 NB Wageningen
I wish to register as a member of the Wageningen Kayak and Canoe Club "WKV De Bovenste Polder".
|NAME + INITIALS :
|ZIP CODE + CITY:
|DATE OF BIRTH:
||______________ SEX: M / F*|
|I DO / DO NOT* wish to hire a place for my own KAYAK / CANOE*.|
|I DO / DO NOT* wish to make use of a RENTAL CONTRACT for club kayaks.|
*Please strike through what does not apply.
If you are also a member of an other kayak club affiliated with the Dutch Canoe Federation (NKB), please fill in the name of the other kayak club and also the NKB membership number:
The undersigned declares:
- To be able to swim,
- To practise the kayak sport at his/her own risk,
- To safeguard the kayak club against the responsibility for any damage to personal properties.
Date: __________________________ Signature: _________________________