QYC Application Form

Name *

First

Last

Date of Birth *

Address *

Email *

Occupation

Phone Number *

Type of Membership *

Family Membership (One person per row)

Membership Categories and Descriptions
Family – Adults residing together permanently as a couple + children under 18
Single Adult – Adults over 30
Single Parent Family – Adults over 30 (single, divorced, separated, or widowed) + children under 18
Junior Family – Over 18 with the elder being under 30 on 01/04/22 + children under 18
Junior 1 – Over 18 and under 25 on 01/04/23
Junior 2 – Over 25 and under 30 on 01/04/23
Cadet – Under 18 on 01/04/23 – No vote
House – Adult – May not use or bring waterborne craft to the club – No visitors – No vote
Introductory – Valid for one year – Sailing dinghies only onsite – No vote

Do you own a boat (includes tenders, Ribs etc

If Yes – Class / Type / LOA

Will You Require Mooring?

Will You Require Winter Hard-standing?

Are you currently or have you been a member of another yacht club?

If Yes Give Details

Have you ever been refused membership or had membership of a club terminated ?

If Yes Give Details

Please give details of previous sailing / boating experience including any RYA or other relevant qualifications held.

Have you ever been convicted as a result of criminal proceedings? (Rehabilitation of Offenders Act 1974 Exemption Order 1975) *

Applies to all Adult Applicants To comply with current legislation, particularly The Children (Northern Ireland) Order 1995 regarding Child Protection please complete.

Do we have permission to carry out a police check? *

Applies to all Adult Applicants To comply with current legislation, particularly The Children (Northern Ireland) Order 1995 regarding Child Protection please complete.

How did you hear about Quoile Yacht Club, why do you want to join and what could you offer the club as a member.

Insurance Declaration *

I understand and agree to the terms.

By submitting this application you are making the following Insurance Declaration:
“I confirm that as a boat/caravan owner and member of QYC, I have and will maintain valid insurance in
force for all of this year to cover my legal liabilities arising directly or indirectly by, or through, in connection with the ownership, possession or use by, or on behalf of myself, my family, my visitors or my crew, of any water craft, caravan, boat trolley or cradle in accordance with QYC Constitution”
If my application is successful I would be prepared to participate in club activities, including serving on committees, doing bar duty, helping at work parties etc.

Data Protection *

I understand and agree to the terms.

The information you provide in this form will be used solely for dealing with you as a member of Quoile Yacht Club. The Club’s Data Privacy Policy can be found on the club website. Your data will be stored and used in accordance with this Policy.
The Club may wish to publish a directory with member’s contact details which will be available to committee members for their sole use, in either electronic or paper versions.
The Club may arrange for photographs or videos to be taken during Club activities and published on our website or social media channels to promote the Club.

If you consent to your data being shared in this way, please agree

Direct Communications

I understand and agree to the terms.

If you would like to receive direct communications from us regarding Club business, sailing events, courses and entertainment you must give your consent.
To indicate you wish to receive club information via email, please agree

We reserve the right to contact you by post or telephone if necessary. You may withdraw your consent or change your preferences at any time by contacting us by post or email.

Please be aware that if you later decide to withdraw your consent it will not be possible to remove your contact details from printed material until such time as the next edition is compiled, which will be on an annual basis.
I declare to the best of my knowledge and belief that the information provided is correct and no information has been omitted or misrepresented. Any information given that is later found to be false will result in disciplinary action, which may include expulsion.

I/we agree to abide by the Constitution and Rules of the Club at all times. *

First

Last

Proposer *

First

Last

Seconder *

First

Last

Proposers and seconders must be full members of the club, not currently serving on the committee or as a trustee.

Date

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