Tay Rowing Club Membership Form

Membership Form

We are very pleased to welcome you to Tay Rowing Club. To ensure we have the correct contact details for you, please complete and submit this form.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Method of payment

Cheque in advanceMonthly standing orderBank transfer
Class of membership
Date of birth*

MonthDayYear
Date
Weight in kg*
Emergency Contact

Please insert the information below to indicate the person(s) who should be contacted in the event of an incident / accident.
Emergency Contact - Name*

First NameLast Name
Emergency Contact - Phone Number*

Area CodePhone Number
Disability

The Disability Discrimination Act 1995 defines a disabled persons as anyone with a physical or mental impairment, which has a substantial long-term adverse effect to carry out normal day to day activites.
Do you consider yourself to have a disability?*

YesNo
If yes, what is the nature of your disability?

Visual impairmentPhysical disabilityMultiple disabilityHearing impairmentLearning disabilityOther (Please specify)
Please detail below any important medical information, in relation to your disability, that our coaches should be aware of
Medical Information
Please detail below any important information that our coaches should be aware of (e.g. asthma, epilepsy, diabetes)
Sporting Information
Please expand on your rowing / sculling preferences if required
Can you swim a minimum of 100m fully clothed?*

YesNo
Are you a member of Scottish Rowing?*

YesNo
Scottish Rowing Membership Number
Rower or Sculler?*

RowerScullerBoth
Bow Side or Stroke side?*

BowStrokeEither
Current Sculling Points
Current Rowing (Sweep) Points
Do you have coxing experience or be willing to cox?*

YesNo
Do you have any rowing coaching experience?*

YesNo
Please outline any coaching qualifications
Do you have any powerboat / launch driving experience?*

YesNo
Provide details of powerboat qualification including dates
Data Protection
Click to view Tay Rowing Club's full privacy policy

Under the current data protection legislation, Tay Rowing Club confirms it will not pass any of the information on this application form to any third party. The only exception to this is to inform our parent organisation, Scottish Rowing, of membership information for the purposes of registering with Scottish Rowing or afflliated race organisers.

I agree that for the purpose of registration Tay Rowing Club may on occasion inform Scottish Rowing information relating to my membership of Tay Rowing Club.
Tick box to agree*

I Agree
Declaration
- I wish to join Tay Rowing Club
- I agree to abide by the conditions of membership set out in the Clubs Consitituion and Rules and Codes of Conduct as published in the Clubs Handbook
- I agree to pay the membership, coaching and other fees as set out by the Club
- I agree to pay any regatta and trailer fees incurred by the Club on my behalf
- I understand all aspects of rowing are undertaken at my own risk
- I confirm that I do not suffer a disability or medical condition that may render me unfit for strenuous exercise and that I have declared any known medical conditions
- I confirm that I am able to swim a minimum of 100m fully clothed
Signature*

Clear
Date*

MonthDayYear
Date
Print name*
Please upload any supporting information including qualification evidence

Cancelof
Should be Empty:

Membership Form

Emergency Contact

Disability

Medical Information

Sporting Information

Data Protection

Declaration