Personal Details

Surname

Forename

Address

Postcode

Daytime /Work Contact Number

Email address

Mobile number

Craft Details

Make

Model

Year

Colour

Data-tag No:

Insurance Details

Broker / Insurer

Policy Number

Expiry Date

Cost     £25.00(2 passport size photos required)     plus     £96.00  for SBC PWC Launching Season Ticket (see * below)

Type of Membership Required: Single / Family circle  cash/cheque

I apply for membership of SOUTHEND WATERCRAFT CLUB and use of the launch facilities at Ness Road site.I accept that if I contravene the rules laid down by SWC Club my membership may be revoked.

I undertake to ensure that my public Liability Insurance will be maintained to include provision for water skiing and towed water toys.

I undertake to display the club sticker at all times (preferably above the water line).

*Use of the launch facilities at Ness Road is subject to the purchase of a Southend on Sea Borough Council Personal Watercraft Launching Season Ticket.  Season ticket conditions will be sent along with the season ticket, which must be displayed on the craft at all times. 

Signature

Date

Legal Note:  I, the member signed above, with full knowledge, assume(s) all risks and potential dangers of participation in activities and events of the Southend Watercraft Club. Therefore, my family and I, hereby release and discharge SWC, its agents and/or officers from any claims, demands, actions, judgements and executions which the undersigned now have or may have in the future for themselves or for the undersigned heirs, executors, administrators or assignees against said SWC, its successors or assigns for any and all personal injuries and property damage which maybe caused by or may arise out of the participation of myself or family in the above described events and understand that riding a personal water craft can be potentially dangerous including damage or injury to myself or property. I understand that SWC is not responsible for dock conditions, weather or other acts of nature. I the undersigned hereby acknowledge that we have read this release and understand all of its terms. I execute it voluntarily and with full knowledge of its significance. I have also read, understood and will abide by the rules, constitution and byelaws of the SWC, and its affiliated partners.

Please send completed application forms to:

Swc

43 Old Mead

Southend-On-Sea

Essex

Ss2 6sw