Student Membership Application



Membership Status:


First Jump Date:

Last Issue Date:

Membership expires on:


Personal Accident Insurance

Issue date:

Expiry date:

Click on the link to view the

Note: Please be aware to update the club's balances MANUALLY after rolling back the issued and expiry dates.

Affiliated Club:

SUNSHINE COAST SKYDIVERS

Would you like to renew membership for an additional 1 month?

Has read and signed the Rules and Regulations:

The membership will be renewed for an additional 1 month from the current month. Your club will be charged by the current student pro rata membership fee amount.



Family Name:

Given Names:

Date of Birth:

People under 12 are unable to self register online, please contact the club you are intending to jump with to make arrangements for your jump.

Gender:


Citizenship:

The Citizenship Country is the country of your current citizenship

Occupation:

Postal Address:

Suburb/Town:

Country:

State:

Postcode/Zipcode:

The Country's Postcode or Zip code can be numeric (containing 4 or 5 digits) or alphanumeric (mixed letters and digits - eg. UK, Canada, etc)

Telephone:

Please provide at least one of the contact numbers - telephone or mobile

Mobile:

Email Address:

Preferred Jump Date:


Do you want to be excluded from mailing lists?

We may make your contact details available to APF officials, Councils and Clubs for marketing purposes. If you do not want any of this information made available, omit it from this form. If you withhold this information, it may restrict our ability to communicate with you. We may make our mailing list available to other organisations (mostly skydiving related) for marketing purposes.


Personal Accident Insurance

Personal Accident (PA) Insurance for the activity of Parachuting is available with this membership application to people between the age of 12 and 75 years inclusive and is considered a valuable member benefit. This Insurance is underwritten by Sportscover Australia Pty Ltd under an authority from Sportscover Syndicate 3334 at Lloyd’s. The policy provides Capital Benefits of $50,000 (or a percentage thereof, depending on specific injuries) for events such as: Death, Total and Permanent Disablement, Quadriplegia, Paraplegia, Loss of use of various limbs, organs and functions; Non-Medicare Benefits covering various expenses that are not covered by the Medicare Act 1983. The policy provides cover only for the activity of Parachuting and only during the period of your membership detailed on your Student Parachutist Licence issued by the APF. Click here for a Product Disclosure Statement and full Policy Document which is also available at all APF Drop Zones or you can request a copy free of charge from the APF. The APF does not hold an Australian Financial Services Licence and you should obtain your own advice about your needs for this product from an appropriately qualified and licensed advisor. You can check your status of cover under this insurance by contacting APF’s advisor, Insuranet Holding Company Pty Ltd on 02 6202 3000.

I the applicant described above do hereby declare that I have read and fully understand the benefits of the APF Personal Accident Insurance being offered herein and further declare that I choose to Opt-Out of this benefit. I do so with the full understanding that I may suffer financial and monetary loss if I die or receive serious injuries from an accident whilst Parachuting and that I now choose to decline any and all benefits provided by this Insurance. I further declare that I have made adequate provisions to protect myself and my dependant’s financial well-being in the event of death or accident whilst parachuting.


I declare that I am the person named in this application and that I have read and understood the WARNING and DECLARATION and that I agree to abide by the RULES and REGULATIONS of the Australian Parachute Federation while engaged in parachuting and associated activities. 

I declare I have no disability which would affect the safety of the parachute jump:


Type of Jump:





Please select the type of the jump that can be applicable to this student registration


Comments:

Source