2023 / 24 Membership

Basic Information

First Name *

Last Name *

Email Address *

Mobile Phone *

Address (Line 1) *

Address (Line 2)

City / Town *

County *

Postal Code *

Country *

Date of Birth *

Including year of birth

CPGA Category

CPGA Membership NumberIf you have a one. This is not a requirement.

Gender *MaleFemalePrefer not to say

Age Category *Selecting Vet or Supervet does not exclude you from racing in the Open catergory

Emergency Contact

Name *

Relationship *

Emergency Phone Number *

Address (Line 1) *

Address (Line 2)

City / Town

Postal Code

Watersports Readiness

Has your GP ever said that you have a heart condition and that you should only do physical activity recommended by him or her? *

YesNo

Do you feel pain in your chest when undertaking physical activity? *

YesNo

In the past month, have you had a chest pain when you were not undertaking physical activity? *

YesNo

Do you lose you balance because of dizziness or do you ever lose consciousness? *

YesNo

Do you have a bone or joint problem that could be made worse by a change in you physical activity *

YesNo

Please give details

Are you pregnant or have you had a baby in the last 6 months? *

YesNo

Is you GP prescribing drugs (for example water pills) for your blood pressure or a heart condition? *

YesNo

Do you know of any other reason why you should not exercise? *

YesNo

Please tick the box to confirm that you can swim 50m+ *

Club Rules

Please tick to confirm your agreement to these rules

Respect *I will treat other members and public as you would expect to be treated regardless of age, gender, ethnicity or ability.

Consideration *I will show consideration and avoid causing offence through language or actions which may bring the club or the sport into disrepute.

Safety First *I will always adopt a safety first attitude. Looking out for myself and fellow rowers. I will follow instructions during launch, rowing and recovery.

Handbook *I have read and understood what is expected of me in the Members Handbook.

Website

Required Username (NEW members only)What username would you like to use to login to the website? Returning members do not need to complete this as they will keep their existing username.

Password (NEW members only)What password would you like to use to login to the website (this can be changed once you have logged in for the first time). Returning members can continue to use their current password.

Membership / Payment

Membership Required *

Full MembershipJuniorNon-Rowing / Cox ONLY

How will you be paying your membership fee? *

BACS - Full amount (Please use surname as reference)Standing Order (5x consecutive payments of £22)Joined AFTER 01 Jan 2023 (Fee not applicable)Please note that you will need to pay your membership via BACS - we do not offer online payment. Standing Order is NOT available for Junior or Non-Rowing Memberships.

Digital Signature

Digital Signature *I confirm that I have read, understood and completed this questionnaire. I understand that I am voluntarily engaging in an acceptable level of exercise and my participation involves a risk of injury. By typing my name here am confirming that I have signed this form electronically.

Non-competitive ‘Club Rower’ fee	£120 per year
Competitive ‘Race Rower’ fee	£150 per year
Social ‘non-rower’ fee*	£10 per year

Non-competitive ‘Club Rower’	5 x payments of £24.00
Competitive ‘Race Rower’	5 x payments of £30.00

EXMOUTH GIG CLUB

Membership Fees

Which am I?

The Club Rower

The Race Rower

Payment

Spreading the Cost

Additional Notes

New Members

Returning Members

2023/24 Membership Form