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Balmain, NSW Australia

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Thank you for submitting your membership application – your application has been received and is being reviewed by our team now.  Once it has been approved, you will receive an email from us confirming your membership.

 

 

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    NeitherAboriginalTorres Strait IslanderBoth
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    Do you have any allergies, require any special assistance, or have any impairment or condition which may impact your ability to row in relation to any of the following areas:
    VisionHearingMobilityCognitionCo-OrdinationOtherNone
    Please check atleast one option.
    Please enter valid data.
    Please Describe your allergies/conditions/or assistance needed:
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    Agreement
    Terms and Conditions
    I will abide by the rules and by-laws of the Balmain Para-Rowing Program Inc., and will follow the reasonable directions of the board, including to pay all subscriptions and debts to the Program as they fall due.
    I have read, understand and will abide by the Program’s member protection and OH&S policies, as amended and placed on its website and/or noticeboard from time to time.
    Except as disclosed on this form, I do not suffer from any condition, injury or ailment that would prevent me from fully participating in rowing activities, or put me at risk of injury or harm if I were to participate in any rowing related activities. I will immediately notify the Program in writing if this changes.
    I understand rowing is a dangerous sport that contains inherent risks – I have read and understand the FISA safety manual* (“FISA Minimum Guidelines for the Safe Practice of Rowing”) and NSW Maritime Code of Conduct for Rowing and Sculling Shells, and I agree to comply with these documents.
    I confirm I can swim 100 metres in rowing clothes, or, if I have any difficulty in doing so, that and the reason(s) for any difficulty are fully set out in this form.
    I consent to the Program collecting, using, retaining and disseminating my personal information (including contact details and photographs) in accordance with its privacy policy, which I have read and understood.
    I understand that the Balmain Para Rowing Program Inc. does not provide personal accident insurance cover for me. This insurance cover is provided by Rowing NSW for its members, as detailed on their website. I understand that to obtain this insurance cover I must register as a member of Rowing NSW, and of a club / school in NSW or another state or territory within Australia.
    In consideration for the Program’s acceptance of my membership, I, including any heirs, executors and administrators (or any other person claiming through or under me), hereby release from, indemnify and waive any and all claim, right, cause of action or suit (including for negligence and gross negligence) (‘Claim’) against the Balmain Para-Rowing Program Inc., its agents, employees, volunteers, coaches, office-bearers or members of the board, or any other person or entity acting with the authority of any of those entities, arising out of or related to any injury, loss of life or damage to property which I may suffer or sustain, or cause to any third party, as a result (either directly or indirectly) of my membership with, or participation in any activity arranged by Balmain Para-Rowing Program Inc.
    I understand this release, waiver and indemnity involves a release of significant legal rights and nevertheless agree to be bound by its terms.
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    Terms and Conditions
    I agree to be bound by these terms.
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      Strength: Very Weak
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      Suburb
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      Postcode
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      Please enter at least 4 characters.
      Maximum 4 characters allowed.
      Please enter valid data.
      *
      State / Territory
      Select OptionAustralian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia
      Please select atleast one option.
      Please enter valid data.
      *
      Country/Region
      Country/RegionAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe
      Please select atleast one option.
      Please enter valid data.
      Contact Information
      Contact Information
      Phone Number (Home)
      Text field can not be left blank.
      Please enter valid data.
      Please enter valid data.
      Phone Number (Work)
      Text field can not be left blank.
      Please enter valid data.
      Please enter valid data.
      Phone Number (Mobile)
      Text field can not be left blank.
      Please enter valid data.
      Please enter valid data.
      Parent/Guardian/Emergency Contact Information
      Complete if under 18
      Parent/Guardian Name
      Text field can not be left blank.
      Please enter valid data.
      Parent/Guardian Phone No.
      Text field can not be left blank.
      Please enter valid data.
      Please enter valid data.
      Parent / Guardian email
      Text field can not be left blank.
      Please enter valid data.
      Please enter valid data.
      Additional Information (Optional)
      Additional Information
      *
      Preferred Language(s)
      Text field can not be left blank.
      Please enter valid data.
      Other Languages Spoken
      Text field can not be left blank.
      Please enter valid data.
      *
      Do you identify as:
      NeitherAboriginalTorres Strait IslanderBoth
      Please select one option.
      Please enter valid data.
      *
      Do you have any allergies, require any special assistance, or have any impairment or condition which may impact your ability to row in relation to any of the following areas:
      VisionHearingMobilityCognitionCo-OrdinationOtherNone
      Please check atleast one option.
      Please enter valid data.
      Please Describe your allergies/conditions/or assistance needed:
      This Field can not be left blank.
      Please enter valid data.
      Agreement
      Terms and Conditions
      I will abide by the rules and by-laws of the Balmain Para-Rowing Program Inc., and will follow the reasonable directions of the board, including to pay all subscriptions and debts to the Program as they fall due.
      I have read, understand and will abide by the Program’s member protection and OH&S policies, as amended and placed on its website and/or noticeboard from time to time.
      Except as disclosed on this form, I do not suffer from any condition, injury or ailment that would prevent me from fully participating in rowing activities, or put me at risk of injury or harm if I were to participate in any rowing related activities. I will immediately notify the Program in writing if this changes.
      I understand rowing is a dangerous sport that contains inherent risks – I have read and understand the FISA safety manual* (“FISA Minimum Guidelines for the Safe Practice of Rowing”) and NSW Maritime Code of Conduct for Rowing and Sculling Shells, and I agree to comply with these documents.
      I confirm I can swim 100 metres in rowing clothes, or, if I have any difficulty in doing so, that and the reason(s) for any difficulty are fully set out in this form.
      I consent to the Program collecting, using, retaining and disseminating my personal information (including contact details and photographs) in accordance with its privacy policy, which I have read and understood.
      I understand that the Balmain Para Rowing Program Inc. does not provide personal accident insurance cover for me. This insurance cover is provided by Rowing NSW for its members, as detailed on their website. I understand that to obtain this insurance cover I must register as a member of Rowing NSW, and of a club / school in NSW or another state or territory within Australia.
      In consideration for the Program’s acceptance of my membership, I, including any heirs, executors and administrators (or any other person claiming through or under me), hereby release from, indemnify and waive any and all claim, right, cause of action or suit (including for negligence and gross negligence) (‘Claim’) against the Balmain Para-Rowing Program Inc., its agents, employees, volunteers, coaches, office-bearers or members of the board, or any other person or entity acting with the authority of any of those entities, arising out of or related to any injury, loss of life or damage to property which I may suffer or sustain, or cause to any third party, as a result (either directly or indirectly) of my membership with, or participation in any activity arranged by Balmain Para-Rowing Program Inc.
      I understand this release, waiver and indemnity involves a release of significant legal rights and nevertheless agree to be bound by its terms.
      *
      Terms and Conditions
      I agree to be bound by these terms.
      Please check to confirm you agree with these terrms
      Please enter valid data.
      Submit