Consent/Taster rows

2 free rowing taster sessions for prospective members!

Thanks for your interest in Clwb Rhwyfo Moelfre- to come for a taster row and see if rowing might be for you, please fill in the form on this page. You'll then be directed to join a Spond group. Once in this group you'll receive notifications when we arrange a rowing session. Please sign up for any sessions that are convenient.

We welcome you to come for a taster on nearly all our sessions. Please just use Spond to sign up to attend convenient sessions and we will arrange things to suit.

Name

e-mail

Phone number

Address

Address 2

City/Town

Post Code

Date of Birth

Age 0

Previous experience

Detail of previous experience

Can you swim 25 metres?

Emergency Contact Details

Name

Address

Address 2

City/Town

Post Code

Phone number

Medical information

Do you have any allergies?

Yes

Details

Have you ever had chest pain or fainted on exertion?

Yes

Details

Has your doctor ever recommended that you shouldn't undertake physical activity?

Yes

Details

Do you have any conditions that could be relevant?

Yes

Details

I have read understood and completed the questionnaire and acknowledge that there are risks and dangers inherent in rowing and physical exercise and duly undertake the activity at my own risk. Moelfre Rowing Club and its members shall not be held liable for any personal accident, accidental damage or loss of life while I am undertaking any rowing or rowing related activities.

If the applicant is under 18 years old, I certify that the applicant has parental consent to undertake club activities.

Dr Simon Burnell is the data controller for the purposes of the Data Protection Act. The information provided on this form will be used for Club data purposes. It can be disclosed to other officers, coaches or volunteers within the Club and to other relevant agencies as necessary. Through joining, I agree for the Club to hold the relevant information.

In order to promote the activities of Clwb Rhwyfo Moelfre, the Club will take, store and reproduce photographs of members and others participating in activities associated with the Club. It is essential that any Member who does not authorise for photographs to be taken, used and reproduced confirms their request in writing to the Club Secretary.

I agree to the terms of service.

If the applicant is under 18 years old, I certify that the applicant has parental consent to undertake club activities.

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2 free rowing taster sessions for prospective members!