Membership Application Form

Westover & Bournemouth Rowing Club

Founded: 1865

Membership Year: The membership year runs from Oct 1st – Sept 30th every year.

Membership Type (Please tick):

____ / £150 / - Full Member _____ £40 - Student Holidays only _____ £80 - Under 18
____ / £100 / - Recreational (Non Racing)
____ / £50 / - Gym Membership Only
____ / £30 / - Basic Membership
____ / £10 / - Associate

Payment Method: (BAC Ref/Cheque/Cash/DD): ______Date paid: ______

Cheques payable to: Westover & Bournemouth Rowing Club. WBRC Acc No: 20-11-39, 20362891

First name: ______Surname: ______

Date of Birth: ______Male ______Female: ______

Address______Postcode______

Email: ______Telephone no: ______

Mobile: ______

Emergency contact name: ______

Emergency contact number: ______

·  I certify that I am an amateur as defined by the rules of the Hants and Dorset Amateur Rowing Association (H&DARA).

·  I certify that I can swim 50m in any water condition (mainly in the sea), swim underwater and tread water for 2 minutes fully clothed & that I am prepared to under a capsize drill as requested

·  I certify that I have received a copy of the Club Safety & Safeguarding Plan

·  My fitness is of a sufficient level to be introduced to active rowing and I do not know of any medical condition that could endanger my health whilst an active rower.

·  I agree to join the above club in the knowledge that I partake in all the club’s activities on or off the water entirely at my own risk and without the responsibility to the club or any of its officials.

·  If elected I agree to abide by all the rules, code of conduct and the bye-laws of the above club.

I agree that my photo can be used in any club publicity or on social media to promote the club & its achievements

I have completed the clubs medical questionnaire and agree for it and this application to be store stored by the club secretary & for its contents to be shared with Committee members & coaches if required

Applicants signature: ______Date of Application: ______

Captain’s signature: ______

If the applicant is under 18 years, this form must be countersigned by his or hers parent or guardian.

Signature of Parent/Guardian: ______Print name: ______

Contact details of Parent/ Guardian______Email: ______

Please return the completed membership form & medical form to the club secretary ()

Membership approval:

The applicant may use the club facilities as a guest of the Club for two trial sessions (water) from the date of application. If approved by the club committee, the membership fee must then be paid to continue using the club’s facilities.

Rowing Status (Please Tick):

Junior (U16) □ Beginner □ Novice □ Junior □ Junior-Senior □ Senior □ Veteran (40+) □

Sculling Status (Please Tick):

Junior (U16) □ Beginner □ Novice □ Junior □ Senior □

Preferred Sweep Oar Side (Please Tick):

Strokeside □ Bowside □

British Rowing Points (If Applicable)

Rowing: ______Sculling: ______

So that we may have an idea of your skills that may be useful to WBRC please complete the following:

Occupation: ______

Additional Skills: ______

Qualifications/Equipment:

RYA powerboat Level 2 □ British Rowing Coaching Level 2/3 □

Licence to tow a trailer □ Access to vehicle with tow bar □ Access to van □

Informal Experience/WBRC Courses: In the past I have carried out/have experience with:

Launch Driving □ Coxing □ Coaching □ Capsize Drill □

Under 18’s

We must have written consent from the parent or guardian of anyone under the age 18, who wishes to become a WBRC club member. All contact will be made directly with that parent or guardian unless written consent is provided to state otherwise. Please contact the Club Secretary who can provide the necessary form for this to be carried out.