Junior Learn To Row Registration - October 2019

Welcome and Sign Up

Please complete this form to register for a place on the Marlow Rowing Club Junior Learn to Row Program. You will get an email confirming your registration and a second one when we confirm your place. The confirmation will contain the payment details and a number of other important pieces of guidance that will help your junior enjoy their time afloat. If you have any questions, please email jltr@marlowrowingclub.org.uk

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* 1. Parent or guardian name

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* 2. Parent or guardian contact details

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Name of child

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* 4. Child's date of birth

Date / Time

Date

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* 5. Child's gender

Male

Female

Prefer not to say

Other

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* 6. Which School Does Your Child Attend?

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* 7. What School Year Is Your Child in?

Year 7

Year 8

Year 9

Other (please specify)

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* 8. Can your child swim 100 metres?

Yes

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* 9. Have your child suffered an injury in the last six months?

Yes

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* 10. If you answered 'Yes' please give details

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* 11. Have they suffered from illness that required you the doctor in the last 6 weeks?

Yes

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* 12. If you answered yes, please give details

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* 13. Are they currently taking any medication?

Yes

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* 14. If yes, please give details

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* 15. Have they, or do they, suffer from any heart conditions?

Yes

Junior Learn To Row Registration - October 2019

Welcome and Sign Up

Question Title

* 1. Parent or guardian name

Question Title

* 2. Parent or guardian contact details

Question Title

* 3. Name of child

Question Title

* 4. Child's date of birth

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* 5. Child's gender

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* 6. Which School Does Your Child Attend?

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* 7. What School Year Is Your Child in?

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* 8. Can your child swim 100 metres?

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* 9. Have your child suffered an injury in the last six months?

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* 10. If you answered 'Yes' please give details

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* 11. Have they suffered from illness that required you the doctor in the last 6 weeks?

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* 12. If you answered yes, please give details

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* 13. Are they currently taking any medication?

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* 14. If yes, please give details

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* 15. Have they, or do they, suffer from any heart conditions?

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* 16. If yes, please give details.

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* 17. Anything else which you feel should be noted?