Title: Registration Form - Hilbre Island Event
Author: ks
Last saved by: Mr. K. Steer
Company: LCC

Liverpool Canoe Club   
Hilbre Island Race

Name(s):

Address:

Emergency Contact Name and Phone No. __________________________________________________

Hilbre Island Race (High Performance Sea Kayak) 13km

Little Eye Race
(Any Craft) 9km

West Kirby Event
(Kayaks under 4 metres) 4km

Hilbre Island Race (Racing Surf Ski or similar) 13km

Little Eye Race
(Double) 9km

West Kirby Event (Juniors under 16) 4km

Hilbre Island Race (Sea Kayak or similar) 13km | | | Little Eye Race (Racing SUP) 9km | | | West Kirby Event Double 4km |

Hilbre Island Race (Double Sea Kayak) 13km

West Kirby Event 
(Open Canoes) 4km

Hilbre Island Event (Team of 3 Sea Kayaks)

Please mark one box ✓

West Kirby Event 
(SUP) 4km

Club:___________________________     Make/Model of Boat: ____________________________________ 
Hull Colour____________Deck Colour_______________  Male / Female     Age (if under 18) ________
I understand that I paddle at my own risk, and I therefore state that should there be any accident neither I or any person or persons acting on my behalf shall make any claim against any member of the organising club or any individual organiser or any person or persons connected with organising this event. (Tick ONE of the following)
 
     I am a Full member of Liverpool Canoe Club (All members have 3^rd party liability insurance) 
or
     My British Canoeing membership No. is ________________ (have 3^rd party liability insurance)
or 
     I accept full responsibility for any 3^rd party accident / insurance claim against me.
Signature: _______________________________                                  Date __________

Under 18's Only - Permission from an adult who is responsible for you.

 I have read the rules and the insurance disclaimer, and I am satisfied that my daughter / son can cope with the conditions prevailing on the day and I give my permission for him/her to enter this race.  
Signed (Parent / Guardian )____________________________                    Date ________