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Application Form
Application Form
Old Monmothians Boat Club
Membership Application Form
Type of Membership: Full / Social
Title Surname:
Forename(s):
Home Address:
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Telephone:
E-Mail:
Occupation [ If student please state school/college ]:
Current Rowing Experience [ give status ]:
Rowing:
Sculling:
Current Main Club:
Names of Previous Rowing Clubs:
Years of attendance at Monmouth School:
Date of Birth: Age:
Can you swim 100 meters in light clothing?
[ You may be asked to demonstrate that you can swim this distance in a swimming pool ]
Medical Details: Do you suffer from Asthma, Diabetes, Epilepsy or any other condition which may arise while exercising?
If "yes" please state which condition(s) and the likelihood of it occurring:
[ Information will remain confidential unless permission is given by yourself to disclose ]
Are you a member of the Welsh Amateur Rowing Association and /or Amateur Rowing Association? (Please state which and give membership number)
Applicant's signature: Date:
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Passed by committee: Date: .
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. Signed:
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