2025 Summer LBRA Rowing Development Camp Registration Form

LBRA Summer 2025 Rowing Development Camp Registration Form

July 11 - August 1 - US High Performance Coach, John Kaitz
Athlete Information
Athlete's Name

First NameLast Name
Email Address
example@example.com
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Home Phone
Format: (000) 000-0000.
Mobile Phone
Format: (000) 000-0000.
Height
Weight
Gender
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Rowing Experience
Years of Experience
Rowing Styles
2K Erg Score
Current College/Club Program
Coach Name
Coach Contact (for reference only)
USRowing Number (if available)
Racing Category
Briefly describe your performance goals for this camp.
Misc.
T-shirt Size
Housing (not included)
How did you hear about this camp?
Camp Fee

Total fee is $625 with 50% due upon registration and 50% due on July 11. Limited seats available.
Payment

Camp fee payment can be submitted via Zelle using the QR code (under regattas@longbeachrowing.org) or by dropping off or mailing a check to: Long Beach Rowing Association, P.O. Box 3879, Long Beach, CA 90803.
Emergency Contact Information
Emergency Contact's Name

First NameLast Name
Relationship
Home Phone
Format: (000) 000-0000.
Mobile Phone
Format: (000) 000-0000.
Email
example@example.com
Questions/comments
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Should be Empty:

LBRA Summer 2025 Rowing Development Camp Registration Form

Athlete Information

Misc.

Camp Fee

Payment