Member Information Form

The following information is specific to each member / unit. Please use this form as a single member or unit both living at the same address, complete separate forms if living at separate addresses, Complete this form for new membership and renewal.

First Person

Address

Date Of Birth

Phone Number

Second Person

Address

Date Of Birth

Phone Number

Car Registration Number - List two if required

Health and wellbeing information

Do you have any medical conditions that the committee (& other members) needs to know about for your safety… if so please list details & action plan (if applicable) below:

Information on who can we contact regarding an accident / property collection if needed:

Next of kin

In the event that I / we no longer access the club due to illness or death we agree for the club to contact the above-mentioned person, in the event that you have chosen to not nominate a next of kin / contact person you understand that all your properties become club property and can be sold by the club or utilised as seen / deemed necessary.

TERMS & CONDITIONS

I have read and agree to abide by the club rules, policies and Bi Laws of CVNC

I acknowledge that CVNC does not accept any liability for personal injury, property damage or loss sustained by any members as a result of their own actions.

I acknowledge that I will check and reply (where required) to all correspondence as sent via text or email from CVNC including email updates, messages, newsletters, invoices and general information to ensure that I am up to date with all relevant information regarding the ongoing running of CVNC

I agree that it is not the duty of the CVNC committee members to chase me up regarding any correspondence issued.

Privacy Notification: The personal information requested on this form is collected by CVNC for the provision of membership. This information will be used by CVNC committee for that primary purpose and/or directly related purposes, e.g. invoicing of fees, rosters/duty, etc.

The information in this form will not be divulged to non-committee members and will be securely stored in the clubhouse and confidential member register

I / We agree and abide by the terms and conditions provided on this page.

Further Questions or Comments