NCSP Membership Registration Form

Upper Delaware River Chapter of The National Canoe Safety Patrol 2025 Membership Registration

Complete the form below to sign up for your 2025 membership.
Make sure to click the Submit button at the bottom of the page once everything is filled out. Thank you!
I plan on attending Spring Training May 2th-May 4th, 2025*

YESMAYBENO
Member Name*

First NameLast Name
Birth Date:*

MonthDayYear
Email*
example@example.com
2nd Person's Name (if more than one person signing up)

First NameLast Name
Birth Date:

MonthDayYear
Email (Not Required unless Different Members of the Family want an Email)
example@example.com
3rd Person's Name (if more than one person signing up)

First NameLast Name
Birth Date:

MonthDayYear
Email (Not Required unless Different Members of the Family want an Email)
example@example.com
4th Person's Name (if more than one person signing up)

First NameLast Name
Birth Date:

MonthDayYear
Email (Not Required unless Different Members of the Family want an Email)
example@example.com
5th Person's Name (if more than one person signing up)

First NameLast Name
Birth Date:

MonthDayYear
Email (Not Required unless Different Members of the Family want an Email)
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Phone :*
Alternate Phone:
Share contact (email & primary phone) with other members?*

YESNO
Emergency contact *

Street Address

Name

Relationship to member(s)

Zip Code
Emergency contact Phone Number*

Area CodePhone Number
Latest First Aid Certification*
Expiration date*

MonthDayYear
Latest CPR Certification*
Expiration date*

MonthDayYear
Any additional rescue certifications
EMT, Swiftwater, etc.
Please add certification information for additional family members if different then above
Attached a copy of your current certifications:

Browse Files
Take a photo of your card or upload the pdf file Cancelof
2025 NCSP Waiver

Statement of individual responsibility and waiver
To download the waiver form to your computer, click the embedded document to open it, then select Download or Save As from the toolbar or menu (on Windows, press Ctrl+S; on Mac, press Command+S), and choose your preferred location to save the file. Fill in the blanks, sign, date, Save and Upload with the button below.
Upload your signed waiver here:

Browse Files
Can also except a photo of the signed waiver Cancelof
Membership Level
Membership Category (see below guide if needed)*

ActiveAuxillaryNew/ProbationaryJuniorReservedHonorary
Membership Caterories
- Active membership, shall be open to all persons 18 years of age, or older who x have successfully competed the requirements of the probationary membership and have remained in good standing
- Auxillary membership, shall be available to those members who wish to be affiliated with the NCSP, but who are unable to meet the training, and/or service standards required to remain an Active member in good standing. Such persons shall be expected to continue dues payment and continue to have all privileges of membership, save that they may not hold office, or vote, and that their public service may be limited to a support role at the discretion of the Commodore.
- Junior membership, shall be open to those persons under 18 years of age, who are sponsored, and directly supervised by an active member who is so authorized by a parent or guardian. Junior members will generally be restricted to support functions, and shall never be exposed to conditions beyond their skill level.
- Reserve membership, shall be available to those members who have completed at least one year of Active membership in good standing, and who wish to remain affiliated with the NCSP, but who are unable to meet the training, and/or service standards required to remain an Active member in good standing. Such persons shall be expected to continue dues payment and continue to have all privileges of membership, save that they may not hold office, or vote, and that their public service may be limited to a support role at the discretion of the Commodore.
- Honorary membership, shall be open to persons whose affiliation will promote the good of the organization. Such membership will be by majority vote of the Executive Board. Honorary membership will not require payment of dues. Honorary members shall not have the right to vote or hold office. Other rights and privileges shall be at the discretion of the Executive Board. Honorary membership shall expire at the end of each calendar year, and may be renewed at the pleasure of the Executive Board.
- New/Probationary membership, shall be open to all persons 18 years of age or older who are joining the NCSP for the first time or reinstating an inactive membership. Members shall remain as probationary until such member has successfully completed a training weekend and have completed at least 4 patrols days supervised by designated veteran members. Probationary members have all rights and privileges of a active members except they may not patrol without a designated veteran member, may not hold office, and hold no vote at any meeting or election. Once a probationary member has completed the minimum requirements defined by the training committee and the board of directors, they will be promoted to Active Member. This Active Membership may be revoked if the member fails to attend the following two annual training sessions.
Annual dues

Single: $30 Family: $60

New/Probationary: Single $60 Family $120
- Annual dues shall be paid per calendar year for returning members in good standing.
- Family membership shall be paid per calendar year for 2 adults in a household. Junior members in a household are included without additional charge.
- New members (probationary) initiation fee will be the 2-year dues for both single membership and for family memberships.Those whose membership has lapsed for more than one calendar year shall be subject to the new member initiation fee.
Pay by check or cash at training weekend or mail check in advance. Make all checks payable to Upper Delaware River Chapter of the National Canoe Safety Patrol, Inc. , P.O. Box 68, Beach Lake, PA 18405

Additional donations are alwasy greatly appreciated.
Have a question, let us know then we will get back to you.
Any questions?
REMEMBER TO SUBMIT USING THE BUTTON BELOW:
Thank you for submiting your registration.

Please remember to bring your signed waiver and proof of CPR/First Aid certifications to Spring Training if you did not upload them here.
Visit our website at

https://www.nationalcanoesafetypatrol.org/
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Upper Delaware River Chapter of The National Canoe Safety Patrol 2025 Membership Registration

Make sure to click the Submit button at the bottom of the page once everything is filled out. Thank you!

2025 NCSP Waiver

Membership Level

Visit our website at

https://www.nationalcanoesafetypatrol.org/