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Athlete's name
*
First
Last
Date of Birth
*
Gender
*
Email
*
School Name
(Students only)
Grade
(Students only)
Mailing Address
(Optional)
Which program best fits your category?
Adaptive
Learn to Row
Military/Veterans
Open/Masters
Youth
Volunteer
Other
Are you able to swim 25yards and tread water for 2 minutes? If maybe, explain under other….
Yes
No
Maybe
List any leadership programs or rowing clubs affiliation, if any…
(Optional)
List any previous athletics experience outside of rowing, if any…
(Optional)
List any disabilities you'd like to share with us, if applicable
List any allergies or dietary restriction you'd like to share with us, if applicable
Parent/Guardian Name
First
Last
Required for students
Parent/Guardian Name 2
First
Last
Required for students
Parent/Guardian Email
Required for students
Parent/Guardian Email 2
Required for students
Parent/Guardian Phone
*
Required for students
Parent/Guardian Phone 2
*
Required for students
Permission & Agreement
*
I agree
As a legal adult self (18+ years old) or a parent/legal guardian of a minor child under the age of eighteen years whose participant name is listed above, I consent to his/her participation in Unity Boat Club Inc. activities under the TERMS and WAIVER listed below.
Liability Release: The youth/athlete/student named on this form would like to travel with and/or participate in group trips or programs or events hosted by or associated with Unity Boat Club. I acknowledge the risks and potential for risks of travel and participating in various sports, however, I feel that the possible benefits to myself/my son/my daughter/my ward are greater than the risk assumed. I hereby intend to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Unity Boat Club, its Board of Directors, Coaches, Aids, Directors, Volunteers and/or Employees for any and all injuries and/or losses I/my son/my daughter/ my ward may sustain while traveling with Unity Boat Club or while participating in, planning, or attending sporting, training and other events as part of Unity Boat Club programming.
Photo Release: I hereby consent to and authorize the use and reproduction by Unity Boat Club (and its partner organizations) of any and all photographs and other audiovisual materials (including film) taken of me/my son/my daughter/my ward while participating for promotional, educational, fundraising and any other use for the benefit of Unity Boat Club and its mission and programs. Examples include photos and videos of athletes that may appear on the websites, press releases, fundraising material, Facebook, Twitter, Instagram and other social media posts, etc
I agree to the following charge:
*
First time registration Fee –
$25.00
Credit Card
*
Billing Address
clubs of
City
State, Zipcode
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