Gravesend Rowing ClubMembership Application

(Please complete in block capitals, delete or circle as applicable throughout)

Personal Details:

N.B. You MUST also complete the attached In Case of Emergency details form (ICE) in full.

Name / Date of Birth
Address: / Sex / Male / Female
Membership Type:
Rowing Adult / Yes / No
Rowing Junior (under 18) / Yes / No
Telephone (H) / Land training only / Yes / No
Telephone (MB) / Have you rowed before? / Yes / No
Contact Email / NB Parent’s if a junior

The contact details you provide may be used to contact you with information and events offered to you by Gravesend Rowing Club. In addition, your email address may be shared within the Gravesend Rowing Club Committee for managingadministration, and for anonymised research and analysis. By providing contact details you consent to your data being used for these purposes.

Health:

Do you have any special need that our coaches should know about? / Yes / No
If Yes, please give details:
Do you suffer from any known medical/physical condition that could affect you during exercise? / Yes / No
If Yes, please give details:

Should a medical condition exist, this will not necessarily preclude you from membership/ participation, but it must be declared. Should you be in any doubt, advice should be sought from your family doctor.

Safety:

Can you swim at least 100 metres in light clothing? / Yes / No
Have you ever completed a rowing capsize drill?
If yes, date: ………………….. / Yes / No

Gravesend Rowing ClubMembership Application

Declaration:

  1. I apply to become a member of Gravesend Rowing Club and take part in its activities.
  2. I agree to adhereto the rules and constitution of the Club and British Rowing.
  3. I understand that membership fees are payable on application either as a lump sum or by monthly standing order.
  4. I consent to Gravesend Rowing Club storing the personal data I have provided in this form under the terms of the Data Protection Act 1984(Unincorporated Members’ Clubs are exempt from registering under section 32(2) of the act.) and subsequent legislation, for the purposes of Club administration, management and anonymised research and analysis.
  5. I confirm that I do not suffer from any disability or medical condition which may render me unfit for strenuous exercise.
  6. I understand in the event of an injury or illness, the Club will endeavour to contact the person(s) named on my ICE form, and give permission for emergency medical treatment to be provided by first aiders and medical professionals if required.
  7. Any changes to personal details, medical information or ICE/contact details should be notified to the club immediately.
  8. I am aware that photos/videos are used at the club for promotional/training purposes.

Please tick this box if you do not give permission for any photo or recording to be made of you/your child, to be used for these purposes by Gravesend Rowing Club.

By signing below you are confirming your agreement with the above declaration.

Applicant’s Name (Please print in full): ______

Signed: / Date:

In the event that the applicant is under the age of 18 at the time of application, this form will need to be countersigned by a parent or guardian.

Parent/Guardian’s Name (Please print in full): ______

Signed: / Date:

......

For Office use only

Details of cash/cheque received______

(To be signed by a committee member)

Gravesend Rowing ClubMembership Application

Membership Fees:

Please note membership fees are due in full annually from 1st January, or pro rata for those who join at a later date. Monthly payment is only by standing order, payable on the 1st of each month.

Our current fees are:

Type of Membership / Annual / Monthly
Adult (over 18) / £300 / £25
Junior (under 18) / £192 / £16
OAP / £216 / £18
Land Training Only / £216 / £18
Students / Visiting students pay £10 for each of the Christmas and Easter holidays, and £60 for the summer holidays. Students rowing all year round pay £16pcm or £192 per year.

Annual payment can be made by cash, cheque or bank transfer. Monthly payment can only be made by standing order.

Bank details

Account name:Gravesend Rowing Club

Sort code: 09-01-52

Account number: 16219701

If you have any queries regarding membership payments, please email our membership secretary via

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Registered charity no. 1167701