Application
Form |
Send this form with a £25 deposit
and two stamped addressed envelopes to:- C L
& A F Dutton, 16 Marion Road, Furnace Green, Crawley, West Sussex.
RH10 6QH |
1. You |
* delete as appropriate |
Surname |
Christian Name |
Date of birth |
Male/Female* |
|
Your Parent/Guardian
I am content for my son/daughter* to take part
in Pathfinders on Water. If the application is accepted, I agree that
there will be a contract between Pathfinders on Water and me on the
terms published.
Parent/Guardian
(Signature/date)
|
Full Address |
Full Name. |
|
3. Your Group Leader |
|
Type of Group |
Postcode |
Full Name of Church |
Telephone |
Leader's Name |
Email(if you have one) |
Full Address |
- I apply for a place on POW.
- If my application is accepted, I agree
there will be a contract between Pathfinders on Water and me as set out
in the Terms of Contract.
- I do/not* have any dietary requirements.
(Please detail on separate sheet.)
- I understand there will be Christian
Teaching
on the venture
- I agree to cooperate with the leaders
at all times
Members Signature
|
|
|
Postcode |
Telephone |
Email(if you have
one) |
Leader's Signature |
Date |
|
Date |
|
|
Please give details of any other information
that the leader will need to know (dietary, health, or disability)
|
Your weight(in clothing) in Kilograms
(for buoyancy aid)
|
|
Can you swim 50 metres YES/NO* |
|
Sailing
Experience
|
|
|