Junior Learn To Row - Register - Marlow Rowing Club

This section is for the parent or guardian's details

Title

First Name *

Last Name *

Email *

House Number and Street

Address Line 2

City or Town

Post Code

Country

Emergency Contact Phone Number *

This section covers your child's details

Child First Name *

Child Last Name *

If you have difficulty adding your child's DOB here, please use the 'anything else box' and we'll fix it at our end

Child DoB *

Gender *

Male Female Other

Able to Swim 100m *

Yes No

Please can you let us know which school your child will attend from this September on.

Child's School *

Child's School Year *

Does you child have any medical conditions?

Is your child currently taking any medication? *

Yes No

If your child is currently taking medication, please let us know the details

Has your child suffered from an illness that required a doctor or specialist in the last 6 months? *

Yes No

If your child has seen a doctor or specialist in the last 6 months, what were the details?

Is there anything else which you feel should be noted?

DECLARATIONS BY THE APPLICANT (ON THEIR BEHALF OF THEIR CHILD)
(1) I confirm that my child does not have any medical or physical condition or disability which would either preclude heavy exercise or put them at increased risk while rowing, and that they can swim at least 100 metres in light clothing.
(2) I understand that my child joining Marlow Rowing Club on a temporary course membership and will only row under supervision and will comply with any safety rules notified from time to time.
(3) I confirm that Marlow Rowing Club may process my personal data and my child's in accordance with its privacy policy.
(4) I confirm that I am the applicant or authorised to make these declarations on their behalf.

Please confirm you agree with the declarations *

Yes No

How did you find out about us?

Junior Learn To Row – Register

Junior Learn To Row - Registration

This section is for the parent or guardian's details

This section covers your child's details