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Have You Ever Completed a Dusi Canoe Marathon Before Yes No

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Have You Ever Completed a Dusi Canoe Marathon Before Yes No KWAZULU NATAL CANOE UNION PO Box 12135 DORPSPRUIT 3206 Forms to be completed by the paddler and submitted to their clubs with the necessary fees, who will then pay KNCU and fax the forms with proof of payment to 086 694 7780, before 16h00 every Thursday afternoon. Registrations received without proof of payment will not be processed and registrations received after the 16h00 cut-off every Thursday will not be processed until the following week Please mark with a X or fill in the box as necessary Have you ever completed a Dusi Canoe Marathon before Yes No Type of Registration First Time Re -Registration Transfer from another Club = CSA Number Initials First Name Surname Home Telephone Cell Number Work Telephone Fax Number Seconders Cell E-mail Date -of -Birth Sex Male Female Club and School if not the same Development Paddler Novice - 1st Year ever registered Race Group – required by Dept of Black Sport and SASCOC reports. White Coloured Indian Asian Disability – brief details Family Membership (3 rd family member onwards and Juniors only) RSA ID Number Postal Address Post Code Registration Date Medical Aid Name Medical Aid Number Medical Aid Main Member Name T Shirt Size S M L XL XXL XXXL Employment Position Occupation Occupation Description Marital Status Married Single Disciplines that you take part in Canoe Polo Dragon Boat Marathon(River and/or Flat) Offshore Ski Racing Rodeo Slalom Sprints Wave -ski Wild Water CSA INDEMNITY : I HAVE READ AND UNDERSTOOD THE INDEMNITY ATTACHED AND DECLARE THAT I AM AWARE OF ITEMS 1. & 2. AND AS SUCH UNDERTAKE TO COMPLY WITH ITEM 3. (a) (b) (c) 4. (a) (b) (c) (d) & 5. AND AS A MINOR’S PARENT HAVE READ AND AGREE TO THE SECTION DEALING WITH MINORS …………………………………… …………………………………… SIGNATURE SIGNATURE OF MINOR’S PARENT/GUARDIAN …………………………………… ………………………………………… SIGNATURE OF CLUB OFFICIAL AS WITNESS DATE TEMPORARY LICENCE FEE FOR NON PAID UP MEMBERS IS R50 PER RACE. PROOF OF PAYMENT OF THE FOLLOWING FEES MUST ACCOMPANY THE REGISTRATION FORM NB: R100 ADMINISTRATION FEE MUST ACCOMPANY TRANSFERS DURING THE SEASON. KNCU-CSA 2018-2019 Registration Fees - FINAL [As per 26 March 2018 members meeting] CSA KNCU Category DUCT TOTAL DETAILS FEE FEE R350.0 R75.0 Seniors R330.00 R755.00 All Seniors 0 0 R110.0 Juniors under the age of 18yrs on the 1 st January 2018 [born on or after 1st January Juniors R140.00 Free R250.00 0 2000] Juniors under the age of 12yrs on the 1st January 2018 [born on or after 1st January Guppy [U12] - 1st Year Free R25.00 Free R25.00 2006] who are registering for the first time. 2nd year of registration will then be as of registration per normal Junior rates. 3rd Family member Free Free Free R0.00 To be eligible for this discount, the 3 rd free family member must be a junior. registering Pro-Rata discount R175.0 R75.0 This 50% discount is valid only for senior paddlers joining their Union and CSA after R165.00 R415.00 Senior 0 0 the 1 st October and only people who have never registered with any Union before. Pro-Rata discount This 50% discount is valid only for junior paddlers joining their Union or CSA after the R55.00 R70.00 Free R125.00 Junior 1st October and only people who have never registered with a Union before This discount is only valid for Undergraduate students, studying a full time degree at a R110.0 recognised university or similar institution and must provide a copy of their student University Students R140.00 Free R250.00 0 card together with their registration form. These students must be under the age of 25yrs on 1st January 2018 [born on or after 1st January 1993] The social membership allows the member to participate in any club time trials, local Social [Juniors & flat water races (excluding any provincial or national championship event) and Surfski R30.00 R70.00 Free R100.00 Seniors] inshore short course races only. To compete in any other provincial and national race event, the member needs to be registered as a full member. All development registrations are controlled centrally by the CSA National Development Co-ordinator, and any registrations in terms of the grid below need to be forwarded to the CSA National Development Co-ordinator at [email protected] Guppy Development Free/R2 Juniors from disadvantaged backgrounds , under the age of 12yrs on the 1st January Free Free/R25 Free [U12] 5 2018 [born on or after 1st January 2006]. First season is free, thereafter R25. Juniors under the age of 18 yrs on the 1 st January 2018 [born on or after 1st January Junior Development Free R25.00 Free R25.00 2000] who are from disadvantaged backgrounds . Senior paddlers [any paddler over the age of 18 - born before the 1st January 2000] from disadvantaged backgrounds who are pursuing representation in one of the ICF recognised international disciplines of marathon, sprint, slalom, canoe polo or ocean Senior Development racing. Paddlers need to apply for the fee exemption if they are not in a position to Free Min R50 Free Min R50 paddlers pay the full affiliation fees. The "CSA Application for Assistance/Exemption" needs to be completed and, together with the necessary information in support of their application, forwarded to the National Development Co-ordinator [[email protected]]. A R50 penalty must accompany all late registrations received by the KNCU office after the 30 September 2018 [New and Junior members exempt] NATIONAL, PROVINCIAL AND CLUB INDEMNITY/SAFETY DECLARATION 1. I am aware of the potential dangers involved to which I will be exposed by participating in canoeing and associated activities; 2. I am further aware that Canoeing South Africa and its affiliated Unions, and all subordinate bodies and officials as well as sponsors of events, in organizing and permitting my participation in such activities and in establishing and enforcing safety measures in regards thereto, cannot ensure my safety and/or the adequacy of such measures. 3. As such, I undertake to: (a) participate in all canoeing and associated activities at my own sole risk and responsibility; (b) exonerate all persons and bodies involved in the organization and sponsorship of canoeing under the auspices of Canoeing South Africa and affiliated Unions from, and indemnify them against, any loss or damage which I or any others, including my dependents, may suffer as a result of any injury or death resulting from any act or omission on the part of such body or person, whether due to negligence (including gross negligence) or otherwise; (c) comply with all safety and other rules and regulations of Canoeing South Africa and all affiliated Unions and subordinate bodies; 4. I undertake to wear a personal floatation device and other safety equipment that conforms to the requirements of Canoeing South Africa, as required by the CSA rules and regulations. 5. I have received and had an opportunity to review the ICF Anti-Doping Rules. (a) I consent and agree to comply with and be bound by all of the provisions of the ICF Anti-Doping Rules, including but not limited to, all amendments to the Anti-Doping Rules and all International Standards incorporated in the Anti- Doping Rules (b) I acknowledge and agree that National Federations and the ICF have jurisdiction to impose sanctions as provided in the ICF Anti-Doping Rules. (c) I also acknowledge and agree that any dispute arising out of a decision made pursuant to the ICF Anti-Doping Rules, after exhaustion of the process expressly provided for in the ICF Anti-Doping Rules, may be appealed exclusively as provided in Article 13 of the ICF Anti-Doping Rules to an appellate body for final and binding arbitration, which in the case of International-Level Athletes is the Court of Arbitration for Sport. (d) I acknowledge and agree that the decisions of the arbitral appellate body referenced above shall be final and enforceable, and that I will not bring any claim, arbitration, lawsuit or litigation in any other court or tribunal. 6. I hereby consent to the use of my image in official broadcast media or promotional use by CSA, and its affiliated unions and clubs. _______________________________________ ____________________________________ SIGNATURE NAME MINORS (UNDER 21 AND NEVER MARRIED) I, the parent/guardian of the abovementioned person, permit him/her to participate at his/her own risk and responsibility upon the basis and subject to the provisions set out above. I consent to the abovementioned person being tested for banned substances, should it be deemed necessary by the relevant qualified authority ______________________________________ .
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