Member registration form Lindisfarne Rowing Club Inc PO Box 73 Lindisfarne 7015 ABN 56 347 813 990 President 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 numberDate of birth Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe 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 depositClub membershipMemberships available Social membership (non voting) Social member (voting) Coaches and coxwains ($0) First year Junior Novice Rower (under 18, non competitive) Junior Rower (under 18 or year 12 competitive) Senior Rower (Plus an additional $400 deposit payable after registration) Veteran Rower (Recreational Veterans & Masters events only) Dragons Abreast Paddlers Dragons Social Paddler (non-voting) Gym membership (non-voting) Junior Rower $250 + $400 deposit Senior Rower $250 + $200 deposit 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 skull storageYesNoSome 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 numberMembership 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*YesNo This iframe contains the logic required to handle Ajax powered Gravity Forms.