Long Beach Rowing Association Membership Form
Please contact membership@longbeachrowing.org with any questions.
LBRA Contact Email
example@example.com
MEMBER INFORMATION
Full Name
Full Name (deprecated)
First Name
Last Name
First Name
*
Last Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email
*
example@example.com
Birth Date
*
/
Month
/
Day
Year
Date
By signing below you confirm that you are a proficient swimmer.
Clear
How did you hear about LBRA?
Please Select
Internet search
Personal friend / word-of-mouth
CSULB
LBJC
I'm a former LBRA member returning to the club
Learn To Row day
Other
Exclude my information from the member directory available to club members
(Deprecated) How did you hear about LBRA?
Did you take any lessons with LBRA?
Yes
No
If you answered yes above, who was your primary instructor?
Please Select
Katrin Gleie
Carlos Recharte
Anna Liberovsky
A.C. DuPont
Hanne Chupik
Other
(Deprecated) If you answered yes above, who was your instructor?
TYPES OF MEMBERSHIP
“Rowing” membership is the standard category entitling the applicant to full use of the club equipment and facilities. A Friends of the Association membership is available to those who wish to be non-rowing members. Family memberships are for an adult couple residing in a common primary residence.
Yearly Membership (October 1 to September 30)
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next
( X )
Rowing (Individual)
$
530.00
Rowing (Family)
$
790.00
Young Adult (18-22 years)
$
260.00
MEMBERSHIP BILLINGS
Continuing members will be billed each year prior to October 1st. Membership dues are due October 1st and must be paid in full. New members joining at times other than October 1st will pay the full membership upon joining. The next October, their dues will be pro-rated for the next year.
VOLUNTEER HOURS
Each member is expected to contribute 12 hours annually to help with regattas, work parties, special events, equipment and facility maintenance, Learn To Row camps, committee activities, etc. Club leadership works hard to ensure ample opportunities for volunteer hours. Members who fail to meet the requirement for volunteer hours may be expected to pay up to $200 in additional membership dues.
*
I understand the volunteer hours expectations.
PROGRAM PARTICIPATION
Competition Level
Recreational
Competitive
Adaptive
Type of Craft
Single
Double
Pair
Wherry
Other
PREVIOUS ROWING CLUB AFFILIATION (if any)
Name of Club
City/State
Currently Active?
SIGNATURE
The undersigned is interested in obtaining membership in the Long Beach Rowing Association and promises to abide by the constitution and by-laws of LBRA and its policies respecting the use of the club facilities and equipment. Member(s) agrees with the membership billing as stated above. Member(s) further agrees that LBRA may hold in its possession and sell its accounts any property which Member(s) may have at the boat house in case of non payment of dues, fees or assessments. Member(s) fully understands Member is fully responsible financially for damage to the Club equipment. Signature below includes agreement of waiver on page two of the official Membership Form available at https://www.longbeachrowing.org/wp-content/uploads/2012/11/Membership-Form-2013-14.pdf.
Signature of new member
*
Clear
Date
/
Month
/
Day
Year
Date
Please verify you are a human
*
Payment Options
Online, via PayPal (see below)
Physical check (checks can be dropped off at the boathouse office)
Other circumstances - please specify
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