Membership Application Form

Rower Informations
Rower's Name *

First Name Last Name

Rower's Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Rower's Home # *

Area Code Phone Number
Rower's Cellular # *

Area Code Phone Number
Rower's E-mail *
Rower's School *
Birth Date *
Age *
Grade *
Gender *
T-Shirt Size *
Have you rowed before *
If Yes, Highest / Last Level?
If Yes, What Position?
What other sports do you Participate in?
I grant permission to WCC to share my E-mail address if another parent request it. *

Yes No
Rower's Signature. *

To sign signature pad, use mouse and hold down button or for touch screens use pen or finger. Clear
Parent/Guardian Information
Parent/Guardian (1) Name *

First Name Last Name

Parent/Guardian (1) Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent/Guardian (1) Home # *

Area Code Phone Number
Parent/Guardian (1) Cell # *

Area Code Phone Number
Parent/Guardian (1) Work #

Area Code Phone Number
Parent/Guardian (1) E-mail *
Parent/Guardian (2) Name

First Name Last Name

Parent/Guardian (2) Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent/Guardian (2) Home #

Area Code Phone Number
Parent/Guardian (2) Cellular #

Area Code Phone Number
Parent/Guardian (2) Work #

Area Code Phone Number
Parent/Guardian (2) E-mail
I give W.C.C. permission to use my child's picture in newspaper articles and on the WCC web page. *

Yes No
Responsible Parent/Guardian Signature. *

To sign signature pad, use mouse and hold down button or for touch screens use pen or finger. Clear
Rower Mandatory Participation

WCC's Learn to Row program will be at Sharpe Reservation. This is our give back service for letting our Club use their lake for practices.
By clicking the box below and electronically signing my name to this registration document I fully agree to and acknowledge that I am aware of my rower's mandatory participation needed in the cleanup day at Sharpe Reservation. I also acknowledge that the date and time of this clean up is TBD *

I fully agree and acknowledge
Responsible Parent/Guardian Signature. *

To sign signature pad, use mouse and hold down button or for touch screens use pen or finger. Clear
Acknowledgement
It is the discretion of our coaches whether a boat is race ready. Based on readiness the rower might not row at a race. *

Rower fully aware and acknowledge Parent/Guardian fully aware and acknowledge
Dues: First year - $530.00 Second year and beyond - $610.00
Dues must be paid in full by February 2nd of rowing season.
Equipment Fund - $100.00 or Family max of $150.00
Must be paid in full by March 31st of rowing season.
Should be Empty:

Rower Informations

Parent/Guardian Information

Rower Mandatory Participation

Acknowledgement