Superior Kayak & Canoe Club Application for Membership:

Name: ____________________________________________________________

Individual or Family: (Circle one) Number of Applicants: _________

Address:_________________________________________________________

________________________________________________________________

Telephone: Home:__________________________________
 
  Cell: __________________________________

  Work: _________________________________

E-mail address: __________________________________________________


Level of paddling experience: (Circle one)

Beginner   Intermediate   Experienced  Advanced


How did you hear about the new club? _______________________________________


Are you interested in any of the following? (circle all that are applicable below)

Willing to organize/ lead some trips Day Trips Weekend Events

Help with a newsletter   Contribute Photos for Website

Act as a Contact Person  

Other (Open to suggestions)…. _____________________________________________________________________

                                                _____________________________________________________________________

                                                ____________________________________________________________________
Please fill out the Membership form AND the Waiver Form.

Membership fee is $15.00 for individuals and $20.00 for a Family membership
Cheques can be made out to Joe O'Blenis
Forms and fees can be mailed to:
Joe O'Blenis
108 Glendale Crescent
Thunder Bay ON
P7C-1N1