Gravesend Rowing Club

Membership Application Form

(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 E-mail* / N.B. Parents (if a Junior)

*The e mail address you provide will be used to contact you with forthcoming news 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. By providing an email address you consent to your data being used for these purposes.


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.


Can you swim at least 100 metres in light clothing? / Yes/ No
Have you ever done a rowing/ sculling capsize drill? / Yes/ No

Gravesend Rowing Club

Membership Application Form


1.  I apply to become a member of Gravesend Rowing Club and take part in its activities.

2.  I agree to be bound by the Rules of the club and adhere to the Safety Rules.

3.  I understand that, upon acceptance of my application, membership fees are payable immediately either as a lump sum or by monthly standing order.

4.  I agree that the personal data for use by Gravesend Rowing Club may be stored on computer under the terms of the Data Protection Act 1984. (Unincorporated Members’ Clubs are exempt from registering under section 32(2) of the act.)

5.  I am aware that video and still cameras are used by the club for coaching purposes and I give permission for any recording, made of me/ my son/ my daughter, to be used for this purpose at, Gravesend Rowing Club.

6.  I confirm that I do not suffer from any disability or medical condition which may render me unfit for strenuous exercise.

7.  I understand in the event of an injury or illness, all reasonable steps will be taken, to contact the person named on my ICE form (or second contact) and that the injury/illness will be dealt with appropriately.

8.  Any changes to personal details, medical information or ICE/contact details should be notified to the club immediately.


N.B. Our ‘fee year’ runs from January to December each year.

I enclose a payment of £...... / I will have arranged a bank transfer of the full year’s fees or pro rata up until December/ I will (have) arrange(d) standing order payments from......

Cheques should be made payable to ‘Gravesend Rowing Club’. Bank details for transfers or monthly standing orders are available from the Membership Secretary at

Applicant’s Name (please print):

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)

Page 1 of 2 Appl form Sept 13