Learn to Row Application Form

First name

Surname

Date of Birth

Gender
FemaleMale

Address



Postal Code

Telephone Number

Mobile Telephone Number

Email

Occupation


Do you have any previous rowing experience? If so please give details.
YesNo

Have you attended a previous taster session at SRC?
YesNo

Can we share your contact details with other club members?


Health

Rowing uses more major muscle groups than any other sporting activity and the primary effects are in the legs, back and arms. Before you consider learning to row please answer the following health questions.

Please indicate below if you have ever suffered from any of the following (This information is confidential but important to your well-being as an athlete).

Asthma
YesNo

Diabetes
YesNo

Blackouts
YesNo

Ear Problems
YesNo

Bronchitis
YesNo

Epilepsy
YesNo

Musculo-Skeletal injuries (e.g. back pain)
YesNo

Are you currently taking any form of medication?
YesNo

If you answered yes to any of the above, or know of any other medical reasons that might affect your ability to row, please give details:

If you have any doubts about your fitness to row we suggest that you should consult your doctor before joining.

Can you swim at least 50m in sports kit?
YesNo

Have you ever done a rowing/sculling capsize drill?
YesNo


EMERGENCY CONTACT DETAILS

Emergency Contact's Name

Emergency Contact's Telephone Number

Emergency Contact's Relation to You


Rowing Aspirations

To help us evaluate your rowing aspirations please answer the following questions.

How many times a week do you exercise currently? Please give details of type of exercise, duration, frequency.

For which of the following water based training sessions are you available?
Saturday 0800Saturday 1000Saturday 1200Saturday 1400Saturday 1600Sunday 0900Sunday 1100Sunday 1300Sunday 1500

For which of the following land based training sessions are you available?
Monday 1900Tuesday 1900Wednesday 1900Thursday 1900Friday 1900

What do you hope to gain from learning to row? Rate the following aspects in order of importance. (1 = most important, 7 = least important)

  • Improve fitness
  • Meet new people
  • Compete in races and regattas
  • Train as part of a crew
  • Receive coaching
  • Be part of a club
  • Explore the river and enjoy nature

Established 1874