Membership Application

external page used for Membership Application form (hidden – do not delete)

Please leave the page title untouched – this is included in the header of this page, and this page uses a customised template which only outputs the HTML header of this page, including navigation, which the new-member script scrapes and injects as the header of the new member script HTML (thus ensuring that any changes to the site menu are reflected in the external script output).

Text like this in the body of the page is not output at all, hence we can leave a helpful notice like this for anyone driving past to understand what is going on here.

MEMBERSHIP APPLICATION

A copy of this membership application will be emailed to you after you submit the form

Upload your 3 completed visitor walk records here*:

(20 Mb total filesize permitted, max 3 files - doc, docx, rtf, pdf, txt, zip archives and image files only)

Your details

I hereby apply for membership of the Sunshine Coast Bushwalking Club and supply the following personal details:

First name*

Last name*

Email*

Street address*:

City*:

State*:

Postcode*:

Country*:

Phone: Home

Phone: Work

Mobile*:

Date of birth*:

Select Date

Occupation:

Current first aid certificate, date renewed:

List of Medical Conditions and/or Physical Disabilities:

List of Allergies:

Emergency contact

First name*:

Last name*:

Mobile phone*:

Your 3 Guest Walks that qualify you for membership:

Walk 1 Location*:

Walk 1 date*:

Walk 1 Leader Name*:

Walk 2 Location*:

Walk 2 date*:

Walk 2 Leader Name*:

Walk 3 Location*:

Walk 3 date*:

Walk 3 Leader Name*:

ACKNOWLEDGEMENT AND INDEMNITY

The term 'bushwalking' where used herein includes but is in no way limited to - all manner of track and off track walking, creek walking, creek swimming, rock hopping, canoeing, cycling, bush camping, abseiling, and similar or incidental activities.

I acknowledge that when I am participating in any activity of the Sunshine Coast Bushwalking Club ('the Club') I am doing so of my own free will in all aspects and as such I accept all responsibility for loss of property, bodily injury or death to me however it may occur.

I acknowledge that my participation in these 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. In particular when participating in abseiling or above the snow line activities I am aware that I may be exposed to additional hazards and risks. Despite such dangers I have chosen, of my own free will, to engage in bushwalking.

I will make all reasonable effort to avoid or minimise these risks by; only participating in activities within my capabilities, carrying equipment and enough food and water appropriate for the activity, and advising the leader if I am taking any medication or have any physical or other limitation that might affect my participation in such activity.

The Club is not liable or otherwise responsible to me for any injury or illness I suffer or sustain when bushwalking nor for the consequences of such injury or illness.

No member of the Club (be they past, present or future) is personally liable or otherwise responsible for any such injury or illness suffered or sustained by me when I am taking part in any bushwalking arranged by, or on behalf of, the Club or otherwise arranged in connection with the Club, nor the consequences of such injury or illness.

I am aware of the aims of the Club and agree to abide by its Constitution and rules. I have read and understand the above Acknowledgement and Indemnity. I acknowledge that the payment of my membership subscription will be deemed as full acceptance.*