Member registration form Lindisfarne Rowing Club IncPO Box 73 Lindisfarne 7015ABN 56 347 813 990President Andrew Lovibond, Secretary Leonie Ellis Use this form to register or renew membership with the Lindisfarne Rowing Club (Tasmania). Name First Last Email Enter Email Confirm Email Phone or Mobile number Date of birth DD slash MM slash YYYY Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Choose your membershipPlease select the club membership you wish to register for, you can select multiple memberships. Please note that some fees include a base fee and a required depositYear of registration*2022202320242025Choose which year your registration is for.Club membershipMemberships available Social membership (non voting) Social member (voting) First year Junior Novice Rower (under 18, non competitive) Junior Rower (under 18, or year 12 – competitive) Junior Winter Program – (April to September) Senior Rower Veteran Rower (Recreational Veterans & Masters events only) Gym membership (non-voting) Dragons Abreast Paddlers Coaches and coxwains ($0) Life Members Total $ 0.00 Preferred payment methodDirect DebitCashCheqeBank Details BSB 067103 Account No. 00902340 Post Cheque to Lindisfarne Rowing Club, PO Box 73, Lindisfarne, 7015 Or pay in person on Thursday club nights Or deposit in the club’s letterbox at the top of the clubhouse stairsClub servicesVolunteering duties Assistance with event and bar work Crew management Assistance with working bees Assistance with fund raising Single scull storage Yes No Some memberships come with single scull storage included (Rowing Memberships), others will need to pay an additional fee. In all cases if scull storage is required select this option and contact a club captain to arrange storage.Junior detailsIf you are completing this form for a Junior (under 18) please provide their details here.Name First Last Email Phone or Mobile number Membership agreementBY SIGNING THIS FORM, THE MEMBER AGREES TO: Abide by the rules and policies of the Lindisfarne Rowing Club, and the directives of the Committee and Officials. Behave in a manner so as not to discredit the Club in any way. Pay all applicable fees when they become due. Accept that failure to abide by any of the above could result in exclusion from the Club. Suspension or cancellation of membership without refund may occur at the Committee’s discretion. Undertake the sport and any training at own risk. Absolve the Lindisfarne Rowing Club Inc., its office bearers, members, instructors and servants or agents from all liability (how ever arising) from injury or damage (how ever caused) whether fatal or otherwise arising out of membership of the Club or participating in training at the club rooms or use of the facilities and equipment or in any way whatsoever due to any negligent act, breach of duty, default and/or omission. Adhere to the requirement that no person uses the facilities of the Club alone, and in particular there must be at least two (2) people (one of whom undertakes a supervising role at all times) in the gymnasium whenever that facility or equipment is being used. I Acknowledge that i can swim at least 100 metres unassisted and fully clothed. PLEASE NOTE: “Non-competitive” means exclusion from competing at Rowing Tasmania Pennant Regattas and events hosted by Tasmanian rowing clubs. Competitive members will have preference over equipment use. Payment is due and payable in full by the 30th September each year. Fees cover membership of the Lindisfarne Rowing Club, (see membership table) registration with the Rowing Tasmania and entry fees to all pennant regattas. This does not apply to masters rowers. The above fees do not cover entry fees at National regattas, Club or School regattas, or any associated costs (such as towing or transport costs for such events), using Club equipment at such regattas, or costs associated with participation at group training camps (e.g. Tamar Regatta is not covered by above fees. Members who damage club equipment are liable for a minimum fee of $25. Heavier penalties will apply for damage resulting from improper behaviour.. I understand and agree to these terms and conditions of membership* Yes No NameThis field is for validation purposes and should be left unchanged.