Applying to join the club:

Type: Junior

To begin the process please enter the relevant details here:

Name of Junior *
Address *
Phone
Mobile
Email *
Please note this address will be used during the registration process
Date of Birth

Medical Form

The following information is needed in case of emergency. Copies will be kept with the Club Captain and all relevant Coaches, and treated in strict confidence.
If you would prefer to complete a paper form please click here

Please state any known medical condition that inhibits strenuous exercise
Conditions

Asthma
Heart Condition
Diabetes
Back and lumbar pain or muscular spasm
Physical Disabilities (please discuss with your appointed coach)

This is not an exhaustive list - please note any other condition which may be relevant. If you have any concerns please consult with your doctor
Other conditions
Please state any allergies or other considerations you have/need should you be hospitalised.
Allergies
Other considerations
Next of Kin
Name *
Address
Relationship to Member *
ICOE Numbers *

Declarations

Please read each declaration and make sure you understand it, then tick the box if you agree with it.

Declaration Agree
As a rower the Junior can swim 100 metres in clothes. Agree
I will complete a paper copy of the Medical Form on behalf of the Junior, and provide it to the appropriate Coach or the Junior Representative for safekeeping. Agree
The Junior will abide by the safety regulations laid down by WARA (the Welsh Amateur Rowing Association). Agree
The Junior has read, understands and agrees to be bound by the Code of Conduct for Rowing Members:
PDF Icon (PDF 110 kB)
A copy signed by the Junior shall be provided to the appropriate Coach or the Club Captain.		 Agree
I have read, understand and agree to be bound by the Code of Conduct for Parents/Carers:
PDF Icon (PDF 143 kB)		 Agree
Submitted by *
Proposed by
Seconded by

Security

To aid us in our quest to defeat the robots, and with them their plan to take over the world one rowing club at a time, please answer the following security question:

Security Please enter this as a word:

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