Summer Learn to Row Camp Registration

Athlete Name*
First Last
Date of Birth*
MM
DD
YYYY
Athlete Email*
Enter Email Confirm Email
Athlete Cell
Athlete School
Year In School*
Multiple Households?*
- Yes
- No
Primary Parent / Guardian Name*
First Last
Primary Address*
Street Address Address Line 2 City State ZIP Code
Secondary Parent / Guardian Name*
First Last
Secondary Address*
Street Address Address Line 2 City State ZIP Code
Emergency Contacts*
Number order in which we should try to call in an emergency.
Name Phone Number
Parent / Guardian Email*
Enter Email Confirm Email
Session Selection
- Session b:10/13-10/24 T/Th 3:45-5:45pm & Sat 9-11am $179
- Session c: 10/27-11/7 T/Th 3:45-5:45pm & Sat 9-11am $179
- Session d: 11/10-11/21 T/Th 3:45-5:45pm & Sat 9-11am $179
- Session e: 12/1-12/12 T/Th 3:45-5:45pm & Sat 9-11am $179
- Thanksgiving Week 11/23-25,27,28 (M/T/W/Th/F/Sat) 9-11:30 am $179
- Winter Break 12/21-23, 28-30 (M/T/W/M/T/W) 9-11am $179
Choose the session you wish to join.

Name	Phone Number