Name *

First Name

Last Name

I would like to be kept up to date with Martlet Club activity by email *

Yes

No

I would like a Martlet Club pin badge *

Yes

No

I am aware that a British Rowing Race Licence (purchased separately) is also required to enter British Rowing events *

Yes

No

I have authorised direct debit payments of £2 per month or £24 per year *

Yes

No

Address for Pin Badge Postage

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country