Have a Go

This form must be completed by a new or returning paddler to waka ama before joining an official Aratika Water Sports Club training session.  Safety is the top priority.  

Membership will be discussed within one month from date of 1st training session.

    Passport Surname*

    First Name*

    Middle Name

    Preferred First Name

    Gender

    Street Address

    Suburb

    City

    Region

    Post Code

    Landline Ph No

    Mobile

    Email (required)

    Date of Birth (DOB)

    Ethnicity

    Main Iwi (Maori)

    Are you able to swim 50 meters unassisted ? yesno

    Are you able to swim 50 meters with life-jacket? yesno

    Can you tread water for 5 Minutes without life-jacket ? yesno

    Can you tread water with a life-jacket for 5 minutes? yesno

    Returning Paddlers only

    Do you hold NKOA ID Card? yesno

    When did you last paddle?

    Name of previous Club

     

    Do you have a disability? Including sight or hearing etc ? yesno

    If you said 'yes' to the previous question, please provide details:

    Name of next of kin

    Mobile for next of kin

    Name of GP doctor

    Doctor's Phone Number

    Name of parent / guardian

    I hereby give permission for media (photographs, video, and images) of myself / my child (18 years and under) to be used by Aratika Water Sports Club Inc on social media such as Facebook and any other platform for marketing purposes. yesno

    Type your name below. This is equivalent to a digital signature

    Date