Northern Phoenix Paddling Club

Member Registration Form

First name(s)

Last name

Date of Birth

Day

Month

Year

Address

Phone

Ethnicity

Details of any medical conditions or allergies (enter 'None' if none)

Details of any medication required (inhalers etc)

Next of Kin (name and contact)

I confirm I have read all Team Resources contained in the link below.

I agree to act in accordance with the Northern Phoenix values.

I confirm I am aware that Northern Phoenix has various policies that govern the club that can be found on the club's website. https://www.northernphoenixdragonboating.com/documents

I am trained in first aid?

Yes

Additional Information

Signature

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Date of signature

Day

Month

Year