SL Crew Club Summer Camp Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Camp Dates: August 19 - 22, 2019, 8 AM - NOON, Spring Lake Middle School, Grand River Access

Email *

First and Last Name of Student

Street Address

City

State

Zip Code

Student's Mobile Phone Number

Student's Email

Age of Student

Birthdate

YYYY

School

Grade entering in the Fall

8th

9th

10th

11th

12th

Other:

Clear selection

Gender

Female

Male

Clear selection

What size T-Shirt do you want (adult men's sizes)?

XXL

Clear selection

PARENT/GUARDIAN INFO

First and Last Name of Parent/Guardian #1

Phone Number Parent/Guardian #1

Email Parent/Guardian #1

First and Last Name of Parent/Guardian #2

Phone Number Parent/Guardian #2

Email Parent/Guardian #2

MEDICAL INFORMATION / EMERGENCY CONTACT INFO

Name and phone number of best person to call in case of an emergency:

Medical / Health Insurance Company

Name of Policy Holder

Policy Number

Medical History / Special Concerns - List any special needs, limitations or adaptations your child has, either physical or behavioral, that we should be aware of in order for your student to participate in all aspects of physical conditioning/training for the sport of rowing:

List any Allergies to medication, foods or other:

Current Medication (prescriptions or other):

Name of Parent/ Guardian providing Digital Signature for questions below:

WAIVER

My child is participating in physical conditioning/training for the sport of rowing. I state that my child is in good health and that all the information on this form is true to the best of my knowledge. I take all responsibility for the health of my child. I authorize the coach or adult volunteers of the Spring Lake Rowing Club to consent medical or dental care or both for my child if emergency contacts cannot be reached. I grant their authority to include administering and authorizing routine medical care, any x-rays, anesthetic, medical or surgical diagnosis or treatment and hospital care under the supervision and upon the advice of a physician and surgeon licensed for medical practice for my child. I further authorize the coach or adult volunteers of the Spring Lake Rowing Club to receive physical custody of my child upon completion of any treatment. I will not hold Spring Lake Rowing Club responsible for any injury to my child and I will take care of all medical costs.

I accept this waiver of liability:

Yes

Clear selection

I give Spring Lake Rowing Club permission to use photos/likeness of my child for promotional use.

Yes

Clear selection

What to wear / bring to camp:

Please bring a swimsuit and towel. There will be a deep water swim test first thing Monday. Must tread water for 5 minutes and practice putting on a life acket that is thrown out to you. For rowing, please wear tight fitting shorts/pants and shirts that can be tucked in. Loose clothes get caught in the seat slides and will damage the equipment as well as potentially injure the rowers and can rip clothing. You should wear or bring running shoes every day. You need to bring a water bottle. A rainproof/windproof jacket is recommended. We will row even if it is lightly raining and/or windy. You'll be very glad to have an outer layer to protect you!

Please remember to pay $100 online to attend.

https://mkt.com/spring-lake-crew-club-inc or go to our website: springlakerowing.com and click "online payments"

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms