Registration Form

Personal Details = required

Full Name

Home Address

Home Phone

Mobile Phone

Email Address

Date of Birth

Gender

Male Female

Occupation

(Please indicate if you would be willing to help the club should it need your expertise.)

Membership Start

When would you like your membership to start?

As Soon As Possible Specific Date

Preferred Start Date
(if applicable)

Membership Category

Please select your preferred membership category

	Category	Cost
	Youth Annual Member Youth Membership is valid for the following sessions: Thursday 5pm to 7pm from April to October Saturday 10am to 12:30pm & 1pm to 3:30pm from April to March School Holiday sessions are available at a discounted rates for youth members Trips are available at a discounted rates for youth members Only available to people between the ages of 8 and 19 inclusive.	£60.00
	Adult Annual Member Adult Membership is valid for the following sessions: Tuesday from 10am to 12:30pm Thursday 10am to 12:30pm Sunday 10am to 12:30pm Access to offsite trip and courses Only available to people between the ages of 20 and 49 inclusive.	£130.00
	Adult Annual Member - Concessions Adult Membership is valid for the following sessions: Tuesday from 10am to 12:30pm Thursday 10am to 12:30pm Sunday 10am to 12:30pm Access to offsite trip and courses Only available to people aged 50 or over.	£110.00

Boat Storage Section

	Category	Requirements	Cost
	Boat Storage - K1 This facility is an option for member to pay for storage of their personal kayak or canoe. It is your responsibility to ensure that your craft is insured for damage or loss. The Leaside Trust do not take an responsibility if damage or loss is incurred whilst your craft is in storage within this facility.	Adult Annual Member Adult Annual Member - Concessions	£100.00
	Boat Storage - K2/Canoe This facility is an option for member to pay for storage of their personal kayak or canoe. It is your responsibility to ensure that your craft is insured for damage or loss. The Leaside Trust do not take an responsibility if damage or loss is incurred whilst your craft is in storage within this facility. Please note: Open canoes will be stored on our car park racking and we advise you attach your craft to this with a suitable lock and chain.	Adult Annual Member Adult Annual Member - Concessions	£150.00

Data Protection

I understand that any personal data I provide on this site will be processed in accordance with the Terms & Conditions and Privacy Policy. I have read and agree to the Terms & Conditions (https://my.leaside.co.uk/Home/TermsAndConditions) and the Privacy Policy (https://my.leaside.co.uk/PrivacyPolicy;).

Signature

Date

Please return completed forms to: The Leaside Trust, The Leaside Trust Spring Lane Clapton London E5 9HQ

Use this form to send an email to another member. You may only send to one member at a time. Your registered email address will be passed on to this member but you may also include alternative contact details.

Note: Emails sent via the website are not entirely private. A copy of every email is held on the database and this can be accessed by the club officers using the Sent Emails page.

From

Alternative contact email

Another email address which the recipient can use to contact you.

Alternative contact details

Other contact details which the recipient can use to contact you e.g. phone number.

Subject

Message

Copy this message to my email address

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