Membership Application

01 MEMBERSHIP TYPE

UNDER 18 JUNIOR CURRENTLY FREE 18 & OVER MEMBERSHIP CURRENTLY FREE

ℹ Selecting Junior will display the Parental/Guardian Consent section below. If you are unsure which category applies, refer to your date of birth in Section 2.

02 PERSONAL DETAILS

FULL LEGAL NAME *

PREFERRED NAME / CALLSIGN

DATE OF BIRTH *

GENDER OPTIONAL

STREET ADDRESS *

SUBURB *

STATE *

POSTCODE *

MOBILE PHONE *

EMAIL ADDRESS *

03 EMERGENCY CONTACT

FULL NAME *

RELATIONSHIP *

PHONE NUMBER *

04 FLYING EXPERIENCE

HAVE YOU FLOWN FPV BEFORE? *

Yes No — I'm brand new to FPV

EXPERIENCE LEVEL

Beginner Intermediate Advanced

AIRCRAFT TYPES YOU FLY

CASA DRONE OPERATOR ACCREDITATION

Yes — I hold accreditation No Not required (under 250g)

05 HEALTH & SAFETY DECLARATION

DO YOU HAVE ANY MEDICAL CONDITIONS THAT COULD AFFECT YOUR ABILITY TO SAFELY OPERATE AN FPV AIRCRAFT? *

No Yes — details below

IF YES, PLEASE PROVIDE DETAILS CONFIDENTIAL

06 MEDIA CONSENT

I consent to photos and videos being taken at IWC events and used in club social media, promotional materials and the club website. I understand I may opt out at any time by notifying the committee.

Leaving this unchecked means you prefer not to appear in club media. We will make reasonable efforts to accommodate this at events.

07 AGREEMENTS & SIGNATURE

I have read and agree to abide by the IWC Club Rules and Code of Conduct. I agree to comply with all applicable CASA recreational drone regulations at all times. I have read and agree to follow the IWC LiPo Safety Guide and to attend the mandatory safety briefing at each event. I acknowledge that Ipswich Whoop Club Inc. is an Incorporated Association governed by the model rules under the Associations Incorporation Act 1981 (Qld), and that my membership is subject to those rules. I declare that the information provided in this form is true and correct to the best of my knowledge.

APPLICANT SIGNATURE *

DATE *

PARENTAL / GUARDIAN CONSENT REQUIRED — Junior applicants must have this section completed and signed by a parent or legal guardian. Membership will not be approved without it.

08 PARENTAL / GUARDIAN CONSENT JUNIOR MEMBERS ONLY

PARENT / GUARDIAN FULL NAME *

RELATIONSHIP TO APPLICANT *

PHONE NUMBER *

EMAIL ADDRESS *

I give consent for the above named junior applicant to become a member of Ipswich Whoop Club Inc. and to participate in club activities. I agree to ensure the junior applicant is aware of and complies with the IWC Club Rules, Code of Conduct, and CASA regulations. I acknowledge that I am responsible for the junior applicant's conduct and safety at all club events, and agree to supervise or arrange appropriate supervision as required.

PARENT / GUARDIAN SIGNATURE *

DATE *