Skip to content
Fishguard and Goodwick Jemima Rowing Club
Main Menu
Home
Information
Membership
Contact us
Joint membership
Leave this field blank
First applicant details (use just this name for setting up GoCardless payment in step 2)
Emergency contact details
Please indicate if any of these apply to you
(optional)
Manual wheelchair user – self propelled
Manual wheelchair user – assisted
Electric wheelchair user
Learning disability – moderate
Learning disability – severe
Visual impairment
Hearing impairment
Amputee
Other physical difficulty
Speech and language / communication difficulty
Please give details of any modifications needed to enable you to access the sport
(optional)
I have read the 'Boat preparation and safety' document and take responsibility for my own health and safety
Second applicant details
Emergency contact details
Please indicate if any of these apply to you
(optional)
Manual wheelchair user – self propelled
Manual wheelchair user – assisted
Electric wheelchair user
Learning disability – moderate
Learning disability – severe
Visual impairment
Hearing impairment
Amputee
Other physical difficulty
Speech and language / communication difficulty
Please give details of any modifications needed to enable you to access the sport
(optional)
I have read the 'Boat preparation and safety' document and take responsibility for my own health and safety
Send
