2023 Post Festival Membership ApplicationThis is an abbreviated membership application for individuals taking advantage of our 2023 special offer to paddle with us for the rest of the season.Step 1 of 250%Personal InformationLegal Name(Required) First Last Nickname (optional)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Cell Phone(Required)Email(Required)Note: We collect your email for membership mailings / newsletters via MailChimp. Contact Information PrivacyPlease be aware that your coach(es) will have access to your date of birth and the above contact information. I consent to share the above contact information with other DHVT membersDragonheart Vermont (DHVT) affirms and promotes participation in all of its activities without regard to race, color, sex, disability, affectional or sexual orientation, gender identity or expression, age, or national origin. Crew determination and eligibility, however, requires disclosure of gender and age. See Crew Determination section below for more information.Please select any that may apply: Cancer Survivor (other than breast cancer) Breast Cancer Survivor BIPOC (Black, Indigenous, People of Color) New PaddlerDragonboat paddling is a water activity. I can swim I am CPR certifiedPlease list any special circumstances that coaches and trainers need to be aware of to make a reasonable accommodation for you to safely participate in our fitness programs.Annual Membership DuesThis special membership package for the remainder of the 2023 season has two options:1. 2023 Post Festival Membership (adults) - Pay $25.00 --- Paddle with DHVT for the remainder of the season. Monday & Thursday with development team and/or Wednesday for a more intense workout --- Option to join us for a travel race (Lakes Region Cancer Support Team Dragon Boat Festival, AKA Gilda’s Club, Laconia NH on September 23rd). Paddlers pay their own travel costs and a $75 paddlers' race fee. --- Option to join our Off Season Training program for Session One (November and December) ONLY. Participants pay approximately $150 fee for two classes per week x 8 weeks. Exact fees set in October.2. 2023 Student Post Festival Membership - Pay $10.00 --- Paddle with DHVT for the remainder of the season. Monday & Thursday with development team and/or Wednesday for a more intense workout --- Option to join us for a travel race (Lakes Region Cancer Support Team Dragon Boat Festival, AKA Gilda’s Club, Laconia NH on September 23rd). Paddlers pay their own travel costs and a $75 paddlers' race fee. --- Option to join our Off Season Training program for Session One (November and December) ONLY. Participants pay approximately $150 fee for two classes per week x 8 weeks. Exact fees set in October.Select Your Membership Type(Required) Paddler (Adult) ($25) Youth/Student Paddler (14-24)($10)Date of Birth(Required)Will be shared with team coaches (for team placement). Month Day YearGender(Required)Used for team placement and compliance with USDBF and IDBF policies on single and mixed gender crews.WomanManNot otherwise specifiedLiabilityClick here to read the Dragonheart Vermont Release of Liability.Consent(Required) I have read, understood, and agree to the Dragonheart Vermont Release of LiabilityLiability for Youth PaddlersIf paddler is under 18 years of age, a parent or guardian must agree to the Release of Liability. Please enter the name of the parent or guardian completing this form below.Current Age of Paddler(Required) Under 18 18 or olderName of Parent/Legal GuardianClick here to read the Dragonheart Vermont Release of Liability.Consent(Required) I have read, understood, and agree to the Dragonheart Vermont Release of LiabilityCOVID-19 GuidelinesIn an effort to protect fellow members and their communities, please note that we follow current COVID safety protocols. Members who experience COVID-like symptoms should not attend practice(s) or DHVT gatherings and events.Emergency InformationYour medical information is made available only to the head coach, your coach, and emergency attendants in case of an emergency.Emergency Contact(Required)Relationship to Member(Required)Contact's Cell Phone(Required)Contact's Alternate Phone (Home/Work)Please list any medical information that you feel is pertinent to medical personnel in time of an emergency.Payment and Next StepsAfter you submit this form, you will be directed to our payment page for a credit card payment.You should receive an email with a copy of this form and a transaction receipt (be sure to check your junk mail if you don't see them promptly).PhoneThis field is for validation purposes and should be left unchanged.
