Henley Rowing Club adult learn to row registration form

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Please fill out this form in order to register for the adult learn to row course beginning on the 17th of February.
After filling out this form please remain patient, an email with further information will be circulated closer to the course start date detailing payment information.

Email *

Name *

Contact number *

Home address *

Age *

18-30

31-50

50+

Gender *

Female

Male

Prefer not to say

Other:

Have you suffered from an injury in the last six months? *

Yes

If you answered yes please give details

Have you suffered from illness which required you to visit the doctor in the last 6 weeks? *

Yes

If you answered yes please give details

Are you currently having to take any medication *

Yes

If yes please give details

Have you/do you suffer from any heart conditions *

Yes

If yes please detail

Please pick which training times you would like (these will be first come first served)

Group 1 - Friday : 6pm-7pm Sunday : 4pm-5pm

Group 2 - Friday : 7pm-8pm Sunday : 5pm-6pm

Send me a copy of my responses.

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