North Lincolnshire and Humberside Sailing Club

Application for membership (all categories) for the 2015 Season

Please return this form direct to the Membership Secretary:

Michael Gamon. 30, St Peter’s Grove, Laceby, Grimsby, N.E. Lincs. DN37 7HD. Telephone: 01472 872684.

(email: ). Please do not give it to anybody else

To the Membership Secretary:

I, the undersigned,wish to apply for Membership of the North Lincolnshire and Humberside Sailing Club for the membership year January 1st 2015 to December 31st 2015. If my membership is accepted I agree to abide by the rules in force at the time. I also declare that I hold a valid certificate of insurance which covers me and my craft against claims up to £2.000.000 including racing risks. I shall continue to hold such a certificate of insurance while I am a member of the club.

I enclose my FIRST ANNUAL SUBSCRIPTION including BERTH AND BOARD RACK FEES as detailed below. I understand that if this application is refused all monies will be returned to me.

*Student Membership is available to adult applicants who are in full-time education.

**A Non-sailing Adult member shall not participate in any on-water activity at the Club or be entitled to a key, or to vote, and this class of membership is only open to new members in the year ending 31st. December in their first year of membership.

*** Junior Members who are not family members, must be sponsored by an adult member

I am applying for (please tick) FULL□FAMILY □*STUDENT □**NON PARCIPITATING MEMBERSHIP□

*** I am a Club member and wish to sponsor the child listed below for JUNIOR MEMBERSHIP □

Name……………………………………………….Name of Spouse or Partner (Family Member)…………………..
Address………………………………………………………………………………………………………………………
……………………………………………………………………………..Post Code…………………………………….
Telephone…………………………..email…………………………………………………………………………………
(PLEASE PRINT CLEARLY)
Names of children under 18 years old on January 1st. 2015 and their date of birth (Family Members)
Name / Date of birth / Name / Date of birth
If you intend sponsoring a child (Junior Member) who is not a family member please complete this section.
Name of child…………………………………………………………..Date of birth…………………………………
Full name of child’s parent or guardian………………………………………………………………………………
Child’s address…………………………………………………………………………………………………………
…………………………………………………………………………………………………Post Code……………
Emergency telephone number……………………………email…………………………………………………….
Signed by parent or guardian…………………………………………………….Date………………………………

Special Skills or Occupation (optional but useful)

Family Membership includes spouse/partner and all their children who are under eighteen years old on January 1st.

2015. Children who are eighteen years or older should join as Full, Family or Student members in their own right.

For subscription rates and sponsor names please see overleaf…

I have the following Sailing Dinghies/Sailboards:

Dinghy or Sailboard Class or type / Identification or Sail Number / Please tick if a berth or rack is required / Please tick if a berth or rack is not required

The Membership Secretary will assign berths and racksas required. Please see charges below. A sticker willalso be issued which must be displayed on your board or dinghy. All craft sailed at the club must be listed above and it should also be stated whether such craft are to be left at the club. The membership secretary should be notified of any change in the number or type of craft sailed at the club.

Fees enclosed
Full Membership £160 (£100 after 31st. August) £………………..
Family Membership(includes children)£190 (£120 after 31st. August) £………………..
*Sponsored Junior Member– (see above)...……… £30£………………..
Student Members £30 £………………..
Non Parcipitating Membership £45 £………………..
Boat berths £20 + £15 for each additional£………………..
Board/canoe racks (but check availability) £20 + £15 for each additional £………………..
Main door key £10, gate key £5 £………………..
Total enclosed£………………..
Please make cheques payable to North Lincolnshire and Humberside Sailing Club
*Please note a Junior member is a person who is under 18 years old on January 1st 2015 A Student member is an adult who is in full-time education.
Declaration; I agree to be present at the club each and every time any of the above children under the age of eighteen are on the premises.
This requirement can be waived for children over 16 years provided that a Consent and Disclaimer form, obtainable from the Hon. Secretary, is returned to the Hon. Secretary signed by both child and parent.
In signing this application I confirm that I agree to the above terms and hold a valid certificate of insurance which provides third party liability cover up to £2,000,000 and which includes racing risks.
Signature of applicant ……………………………………………………………….Date
To be completed by all Students applying for Membership
University or College attending / Course followed / Date of course
From / Date of completion

*The fee for every dinghy berth and sailboard rack must be included in your remittance.

Applications are considered at the Next General Committee Meeting following your application. This is generally held on the first or second Monday of the month

Please indicate what disciplinein which you are interested eg: dinghies, windsurfers, canoes, swimming, other
Thank you.