Membership Details Form * ONE FORM TO BE COMPLETED PER MEMBER Due to Health and Safety, and legislation, your membership is void, irrespective of payment of subscription, if you have not completed a membership form. ALL members of 18 years old and over, irrespective of membership type, MUST complete a membership details form. For ALL members under 18 years old the form can be completed by the ‘minor’ and signed by the guardian, or completed in full by the guardian. Type of Membership*SingleCoupleFamilyTemporaryFull Name* First Last Email* Enter Email Confirm Email Mobile Phone Number*Phone Number: (country code, space, number)Full Name of Account Holder (if not you) First Last For Couples and Families, this is the person who first took out the membershipEmail Address of Account Holder (if not you) For minors: Guardian contact details First Last Guardian Phone NumberTelephone NumberHiddenFor minors: Guardian contact name and telephone number?NIE number (or Passport number)* Year of birth* Nationality* AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Are you a permanent resident of Spain*NoYesNormal Town of Residence when in Spain* City Emergency Contact Details:* First Last Mobile Phone Number for Emergency Contact (format: country code, space, number)*Emergency Contact Phone Number: (country code, space, number)Are you a boat owner? Please selectNoSailingMotorIf boat owner: builder, model, name & where moored. Boating experience. Please selectNoneBeginnerGoodExperiencedBrief synopsis of your experience (optional)Where have you sailed...Do you have any national skippers licence? Please selectNoYesLicence country, issuing authority and level? Licencia Federativa Number (SomVela) It is a club requirement that all members who sail on club events take out adequate insurance (or sign a waiver if they wish to sail without insurance). The SomVela annual Licencia Federativa sailing insuarnce covers all types of sailing throughout the EU and is a requirement of the Real Club Náutico Calpe if you sail on one of their TOM 28 yachts.Crewing I would like to crew for other boat owners What type of crew are you?* Cruising Racing Contact Agreement* I agree my contact details may shared with other members Terms and Conditions Acceptance* I confirm my acceptance of the CBYA Terms and Conditions Personal Data Agreement acceptance* I confirm my acceptance of the disclaimer below. I agree that the CBYA can hold my personal data in order to send me relevant information about club activities and to carry out the administration and promotion of the club which may include media materials for the club website and Facebook pages. I may at any time exercise my right to modify my personal data by updating this form and/or writing an email to info@cbya.org. CommentsThis field is for validation purposes and should be left unchanged. 97235