Canoe Education Canoe Education Weekend Oct 17th – 18th, 2015, Forth River (North) Canoe Tasmania will conduct the following courses at the Canoe Education Weekend at Forth. Please select the course that you wish to attend (Registrations Close 9TH October): Basic Skills and Safety Cost: $25 ($20 for affiliated canoe club members) Saturday Oct 17th, 9.30am – 11.30am Turners Beach boat ramp Essential skills for safe paddling, suitable for beginner to intermediate paddlers, any type of kayak, to be held on the Forth estuary. Participants must have their own kayak and PFD (life jacket). Sea Kayaking Skills Cost: $45 ($35 for affiliated canoe club members) Saturday Oct 17th, 12.30pm – 4:00pm Turners Beach boat ramp Intermediate skills for sea kayak paddlers – surf launching and landings, paddling skills, rescues. Participants must have their own sea kayak. Whitewater Skills - Saturday Cost: $95 ($80 for affiliated canoe club members) Saturday Oct 17th, 9:30am – 4pm Forth Canoe Course Whitewater Skills – one day course developing whitewater paddling skills on Grade 2-3 water. Small group instruction from some of Tasmania’s best whitewater paddlers and qualified AC instructors. Whitewater Skills - Sunday Cost: $95 ($80 for affiliated canoe club members) Sunday, Oct 18th, 9:30am – 4pm Forth Canoe Course Whitewater Skills – one day course developing whitewater paddling skills on Grade 2-3 water. Small group instruction from some of Tasmania’s best whitewater paddlers and qualified AC instructors. Flatwater Guide/Lifeguard/Instructor Course Cost: $265 (plus $155 AC registration fee if seeking assessment for Guide/Instructor and successful) Saturday - Sunday, Oct 17th – Sun 18th, 9am – 4 pm Australian Canoeing accredited course for teaching skills and leading trips on flat water. Assessment options for: Flatwater Lifeguard, FW Guide or Instructor available. Whitewater Guide/Instructor Training Course Cost: $265 Saturday - Sunday, Oct 17th – Sun 18th, 9am – 4 pm Forth Canoe Course Australian Canoeing training course for teaching skills and leading trips on moving water up to, and including, Grade 2 for experienced paddlers. This training course is a strongly recommended pre-requisite for anyone wanting to go for the Australian Canoeing Whitewater Instructor Assessment at a future date (1.5 days assessment, separate). This is not an introduction to Whitewater Skills course (see above 1 day courses for Skills development), but for experienced paddlers looking at demonstrating correct stroke technique in an instructing situation on moving water, breaking down and teaching stroke technique, whitewater rescue techniques and the requirements for Whitewater Guide/Instructor Assessment. Whitewater Guide/Instructor Assessment Cost: $110 (plus $155 AC registration fee) Oct 17th – 18th, Starting 9am Saturday (1.5 days, finishing lunchtime Sunday). Forth Canoe Course Assessment for the Australian Canoeing Award of either Guide or Instructor for guiding/teaching skills and leading trips on moving water up to, and including, Grade 2. Students Whitewater Skills Course (TBC) Cost: $25 Saturday - Sunday, Oct 17th – 18th, Forth Canoe Course Times by arrangement Two hour, whitewater skills sessions for students run by trainee whitewater instructors working under the supervision of AC qualified whitewater instructors and assessors. Note this only runs if there are enough participants going for an assessed qualification for WWG or WWI – contact Development Officer to confirm details. Camping at Forth Canoe Course Cost: $5/night Enrolment Form Name: Address: Email: Phone: Emergency Contact: Name & No Age if under 18: Paddling/Instructing Experience (outline any previous kayaking/canoeing activities and experience you have): Payment Options (to be made prior to the course): Cheque/Postal Order Make payable to: Canoe Tasmania Post to: Direct Deposit Include your name as reference. Return Registration Form to: Canoe Tasmania GPO Box 25 Hobart, Tas 7001 Canoe Tasmania Inc. MyState Financial BSB: 807009 Acc No: 12245398 Canoe Tasmania GPO Box 25 Hobart, Tas 7001 Total Amount Paid: $ Include transaction receipt Email: canoe.tas@canoe.org.au Medical Questionnaire & Consent Do you suffer from any medical condition, illness, injury or disability that may interfere with or be aggravated by the proposed activity? If yes, details: YES / NO Is the abovementioned condition likely to require any special attention, treatment or medication during the activity? If yes, details: YES / NO Have you ever had a serious allergic reaction to an insect, animal or plant? If yes, details (including reaction & treatment): YES / NO Can you swim the length of an Olympic Swimming pool? YES / NO Indemnity Agreement & Waiver of Liability Teaching, Training & Assessment Events Participants Name: Age if under 18: I / we hereby acknowledge and understand that I / my son / my daughter / my dependent will be participating in a Canoe Tasmania Canoe Education event, and that I fully understand the nature of the activity to be undertaken after having read and understood any printed material supplied to me and after making enquiries to my satisfaction. In consideration of the Canoe Tasmania Inc. providing this activity for me / my daughter / my son / my dependent I hereby acknowledge that Canoe Tasmania Inc. and Australian Canoeing Inc., their Instructors, employees, officers, servants and agents shall not be liable for any injury, damage, loss, claim or demand whatsoever which may arise during, or in association with, participation in or travelling to or from the activity unless the same is caused by negligence or a criminal act on the part of the said Canoe Tasmania Inc. or Australian Canoeing Inc., their Instructors, employees, officers, servants and agents and I / we hereby agree to indemnify and keep indemnified the said Canoe Tasmania Inc, Australian Canoeing Inc., their Instructors, employees, officers, servants and agents against all actions, suits, damage claims and demands arising out of any accident, loss or illness which may befall me / my son / my daughter / my dependent during or as a result of my / his / her participation In any activity or function connected with the event or whilst travelling to or from the said event unless the same is caused by negligence or a criminal act on the part of the said Canoe Tasmania Inc. or Australian Canoeing Inc., their Instructors, employees, officers, servants and agents. Signed By: Name (printed): Date: (To be signed by Parent or Guardian if participant under 18 years of age) Consent For Emergency Transport &/Or Medical Attention I, _______________________________ (full name) of: _____________________________________(address) hereby give consent to being transported by Ambulance or other appropriate transport to the nearest medical centre or hospital for emergency or life preserving treatment by an appropriately qualified medical person. Signed (parent/guardian if under 18): Name: Date: