Email*

Phone*

Participant name*

Age of participant*

Contact name of guardian (if under 18)

Preferred contact method*
PhoneEmail

Gender*
MaleFemaleOtherPrefer not to say

Tell us a little about why you're interested in learning to row (e.g. to try something new, interested in competing, wanting to get fit etc...)*

Can you swim 50m fully clothed?*
YesNo

Can you comfortably lift 20kg?*
YesNo

Please detail any health issues or medications that may impact your ability to row, if nil, please state nil.*

Do you currently participate in a regular sport or exercise program? Briefly outline*

Have you rowed before?*
YesNo

Suburb where you live*