ADULT MEMBERSHIP REGISTRATION & DECLARATION FORM
Please note that this is NOT confirmation of a booking on camp. A booking is ONLY complete once full payment has been recieved.
First Name *
Your answer
Surname *
Your answer
Course *
Home Address
Your answer
Postcode
Your answer
Age *
Your answer
Date of Birth *
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Email Address *
Your answer
Contact Number *
Your answer
Primary Emergency Contact *
Your answer
Secondary Emergency Contact
Your answer
Occupation
Your answer
Previous Rowing Experience *
Required
Where to you want to take your rowing?
While at the boathouse & on the water you agree to follow the club safety rules. By signing this declaration you agree to adhere to the TKSS and British Rowing Code of Conduct at all times. *
Photos may be taken from time to time for advertising, use on our website or social media sites. Do you consent to this *
Medial and Personal Health. Rowing and its associated training can be a strenuous activity. By completing this declaration you are confirming that you are in good health and have no medical or physical condition which may precluding you from heavy exercise, if there is any doubt, consult your doctor before completing this declaration. You have a duty to declare any condition that might put yourself or others at risk at this time or any time in the future. *
Required
Please list any condition & special requirements below. It is your duty to personally advise the Coach before your first session if there is any condition they should be aware of in the event of an emergency. i.e. asthma, diabetes etc.… You MUST bring any required medication to EVERY session. Without it you will not be allowed in the session. If none are required then please answer with 'nil'. *
Your answer
Swimming Requirement: For safety, it is important that you are a competent swimmer. At a minimum, you must be able to swim 50 meters in light clothing. If you cannot meet this requirement, you must wear a buoyancy aid at all times when in a boat. It is your responsibility to request a life jacket at each session *
Required
Declaration *
Required
Date Completed *
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This form was created inside of Team Keane Coaching.