Wufoo

Spring Middle School Learn to Row

Thank you for choosing to sign up for WRC's Middle School Learn to Row!

After you submit the sign-up form, you'll be taken to another page to submit payment by credit card.

Please also be sure to register with USRowing and complete the Swim Test Form.
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The information collected is for administrative purposes and is also provided to coaches to ensure they are aware of health issues. We respect the privacy of all our athletes and will not share information provided with anyone outside WRC.

Student and Parent Contact Info
Rower Name * First Last
Parent Name * First Last
Parent Phone * ### - ### - ####
Parent Email *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Joint Level 1 and 2 Sign-Up

MAKE A SELECTION HERE TO SIGN UP FOR BOTH LEVEL I and LEVEL II CLASSES TOGETHER. WRC recommends students take Level 1 and 2 back-to-back and offers a $50 discount for joint sign-up. However, if you need to sign up for only Level I at this time, you can skip this section and do so below. You can still sign up for Level II later.
Select a Choice *
Session 1 AND Session 3 : Apr 9 - May 30 M/W/F Session 2 AND Session 4: Apr 10 - May 29 T/Th/Su I am only signing up for one session at this time. (Make your single session selection below.)
Level I Single Session Sign-Up

IF YOU SIGNED UP FOR JOINT LEVEL 1 AND 2 SESSIONS ABOVE, SIMPLY SELECT THAT OPTION BELOW HERE.
Select a Choice *
I have made a joint Level 1 and 2 selection above. Session 1 only: Apr 9 - May 4 M/W/F Session 2 only: Apr 10 - May 6 T/Th/Su
Student Personal Information
Gender *
Male Female
Date of birth * MM / DD / YYYY
Height *

Format example: 5'2''
Grade *

Student's grade at time class starts. Format example: 7
Middle School *

Format example: Forsythe
Expected High School *

Format example: Skyline
Student Health and Emergency Info

All classes are overseen by a CPR/FA certified coach. In case of a serious emergency, rowers will be taken to the emergency room at St. Joe's.
Emergency Contact * First Last
Emergency Contact Phone * ### - ### - ####
Alternate Emergency Contact * First Last
Alternate Emergency Contact Phone * ### - ### - ####
Name of Doctor or Hospital Emergency Contact
Doctor or Hospital Emergency Contact Phone ### - ### - ####
Emergency Medications
Allergies
Media Release and Feedback

Sometimes coaches take pictures or video taken during Learn to Row practices to help with instruction. Please let us know if WRC may use media in which you appear in our marketing materials.
Select a Choice *
Yes, I consent to allow WRC to use pictures or video in which I appear for marketing materials. No, I would prefer that WRC not use pictures or video of me in marketing materials.
How did you hear about WRC Learn to Row? *
School Newsletter/Flyer Facebook Ad Word of mouth Other
If you selected "Other" in the above, please enter specifics below
Do Not Fill This Out

Wufoo

Student and Parent Contact Info

Joint Level 1 and 2 Sign-Up

Level I Single Session Sign-Up

Student Personal Information

Student Health and Emergency Info

Media Release and Feedback