Membership 2022/23
Sign in to Google to save your progress. Learn more
Email *
First name *
Surname *
Postcode *
The rest of your postal address *
Mobile number *
Landline number
Emergency contact (name, phone number and relation to paddler) - preferably someone who isn't paddling. *
Please list any medical conditions or disabilities that we need to know about e.g. asthma, diabetes etc.
Non-swimmers are welcome in the boats but we need to know who you are so please always inform the helm and your buddy in the boat and tick the box below.
Membership is £60 for the year, payable in one lump sum or £5 per month payable by the 5th of each month. Guest paddlers are £5 per paddle.  Bank details: Sort code 82-68-00, Account no. 60048899. Please use your name as reference.
Clear selection
Data Protection *
A) I wish to be added to the Email contacts list B) I agree to my contact details being shared with other PfLW members when necessary C) I agree to my photo being used in promotional materials and on the web. Please tick all that apply to you.
Required
Have you ever paddled in one of our dragon boats? *
On which side do you paddle?
Clear selection
Is there anything else you would like to add? (e.g. how you heard about Port Edgar Dragons)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy