Henley Rowing Club Junior learn to row registration form
Please fill out this form in order to register for the junior learn to row Summer camp on the 5th - 9th Aug.
After filling out this form please pay £250 to the following details : account no. 60461644 Sort code 20-39-53 and email LTRcoach1@gmail.com to confirm payment has been made.
Email address *
Parent /Guardian name *
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Parent / Guardian Email address *
Your answer
Parent / Guardian Contact number *
Your answer
Home address *
Your answer
Name of child *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Gender *
Child can swim 100m *
Required
Have they suffered from an injury in the last six months? *
If you answered yes please give details
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Have they suffered from illness which required you to visit the doctor in the last 6 weeks? *
If you answered yes please give details
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Are they currently having to take any medication *
If yes please give details
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Have they/do they suffer from any heart conditions *
If yes please detail
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Anything else which you feel should be noted please detail here
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A copy of your responses will be emailed to the address you provided.
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