Taunton Rowing Club September 2015/16 Membership Application All membership applications are subject to approval by the Club Management Committee; all monies will be returned if your application is turned down

Name Address inc. Postcode: Tel. Home: Mobile: Email address:

Please write clearly. Must be a parent/guardian’s email address for U18s. Date of Birth: Please detail any medical conditions and allergies: Rowing status & points Status Points: Sculling status & points Name Relationship Contact number Emergency contact: 1. All 3 compulsory for 2. Juniors 3.

I wish to apply for the following membership: Number Amount Ordinary £100 / year Junior (Under 18) £50 / year Learn to Row (L2R): If you completed this course part way through the current year, the pro rata membership fee will apply and then for the following year (2016/2017) a full 25% discount will apply on the annual membership fee. Student £50 / year (F/T education – university) Social £20 / year Family (inc 1 full Please contact membership secretary member) ...... Adults ...... Juniors Private boat racking £50 / year Boat name & Club number Please make cheques payable to Taunton Rowing Club Total £ Account details HSBC Taunton Branch Total £ Sort code 40–44-04 Account 92044714

Please complete the following and sign at the bottom

 I understand that rowing can be a dangerous sport and it is essential for me to be able to swim proficiently. I hereby declare that I can swim 50 metres in light clothing and I undertake all activities of the Club entirely at my own risk  All members of Taunton Rowing Club will need to perform a capsize drill and pass a swim test  I have/have not (delete as appropriate) completed a capsize drill/swim test  I accept that I must act in support of the aims of the Club, its members and British Rowing  I agree/do not agree (delete as appropriate) to my phone numbers and email address being shared only with Taunton Rowing Club members  I agree/do not agree (delete as appropriate) to photos of me/my son /daughter (if under 18) being used for publicity purposes for Taunton Rowing Club I agree/do not agree (delete as appropriate) to my name/my son/my daughter (if under 18) being included in social media websites dedicated to Taunton Rowing Club I give/do not give (delete as appropriate) my permission for video recording of myself/son/daughter (delete as appropriate) for the purposes of coaching technique.

Signature of applicant: ______Date: ______

Signature of parent / guardian (if under 18): ______Date: ______Additional information (optional) I would be interested in becoming involved with coaching/ marshalling/ trailer or launch driving /committee or other club activities:...... Occupation ...... ………………………………...... Please return form with your membership fee to: Gill Hawkey, Glenside, Riverside, Taunton TA1 1XG ([email protected])

TRC only: LR2 Paid Form Email Cap