Print this, fill it in, and send it off.
 
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
Your Height



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


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