Course Enrolment Form
Please select the course you wish to join
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Course Commencing 14/11/2026
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
Suburb
State
Post Code
Your Gender
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Male
Female
Your Age
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Email Address
*
example@example.com
Mobile Number
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Please enter a valid phone number.
Format: 0000 000 000.
Where did you hear about our courses
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Google Search
Canning Bridge Rowing Club Website
Rowing WA Website
Word of Mouth
Referred by a Member
Sign/Flyer at the Club
Other
Do you have any medical ailments or conditions that may be affected by rowing; things we should be made aware of? If so please advise below. If you are all good write No or Nil in the space.
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Terms and Conditions of Enrolment in a course
We will attempt to adjust instruction to suit, however responsibility for personal care remains with the participant if carrying an injury. I confirm I am able to swim at least 100m. I confirm I am not suffering an illness or medical condition, other than declared above, that may put myself or other rowers in danger while participating in the instruction provided by Canning Bridge Rowing Club. I agree that I am participating in this learn to row course at my own risk and whilst all due care will be taken by Canning Bridge Rowing Club, I will be responsible for my own safety. By submitting this form I agree the conditions and agree that the information given is correct. Fees paid for courses are non-refundable however if you cannot make a particular course you have signed up for then you can change to another future course at no charge. From time to time Canning Bridge Rowing Club members may take photos or videos of me being given instruction or just rowing. Some photos or videos may be placed online in a private You Tube channel for my own viewing or for others if I choose to share a link. Photos may be used on websites or in promotional media.
Please confirm acceptance of the above terms
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I agree
I do not agree
Submit
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