Membership Application Form

Full Details can be found at www.seka.org.uk
Internal use only
Please Sign & Post after Printing
(Approval Date…………………..….)
 
(SEKA Ref …….….……………..…)
Full Name
Address
Postcode
County
Birth Date
Tel / Mobile No
Next Of Kin Emergency Contact No.
Email
SEKA Forum name
Insurance Reference
No.
Kite Interest (delete as applicable)
Static Flying
/
 
Boarding
/
Buggying
/
 
Kite Surfing
/
Other (give details)

I, THE UNDERSIGNED, HEREBY CERTIFY THAT ALL THE INFORMATION GIVEN IN THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THAT I HAVE NO PHYSICAL OR MENTAL IMPAIRMENTS WHICH WOULD LIMIT MY PARTICIPATION IN KITING ACTIVITIES. I HEREBY APPLY FOR MEMBERSHIP IN THE SOUTH EAST KITING ASSOCIATION. AND AGREE TO ABIDE BY THE RULES OF THE ASSOCIATION. I, THE UNDERSIGNED, HEREBY RELEASE SOUTH EAST KITING ASSOCIATION AND ITS OFFICERS, MEMBERS, AND AGENTS FROM ANY LIABILITY FOR DAMAGE, INJURY, OR DEATH TO ANY PERSON OR PROPERTY RESULTING FROM MY PARTICIPATION IN ANY SOUTH EAST KITING ASSOCIATION ACTIVITY.
I confirm that I have suitable insurance cover for public liability.
I also agree for the SEKA to hold my details on computer for as long as I remain a member.

Signature................................................ Date.....................................................
Send along with a stamped addressed envelope to: (No return envelope no can do!!!)
P.O. Box 37, Leatherhead, Surrey, KT22 8YL
We will send you membership confirmation as soon as possible
Please note: currently membership is free and we will do our best to keep it that way. We try to give you what you want so are always asking about ways the club can develop – this may have to include a minimal charge sometime in the future but we will ask you first