Learn To Row Membership Application Form

Rower's Information
Rower's Name*

First NameLast Name
Rower's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Rower's E-mail (Not their WCSD email)
Rower's WCSD E-mail
example@wcsdny.com
Rower's School*
Parent Acknowledgement*

I understand that the athlete must be an actively enrolled student at one of the four Wappingers District schools (John Jay, Ketcham, Wappingers Junior High or Van Wyck Junior High) for the duration of the program in order to participate in Learn-to-Row.
Birth Date*
Age*
Grade*
Sex*
Height*
Weight*
Can the rower swim?*
What other sports or activities does the rower participate in?
How did you hear about WCC?*

New Student OrientationAnnouncementsFriend/FamilySocial MediaOther
Parent: I give Wappingers Crew Club permission to use my child's picture in newspaper articles, advertisements, Wappingers School District webpage, and on the Wappingers Crew Club web page.*
Responsible Parent/Guardian Signature.*

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

First NameLast Name
Parent/Guardian (1) Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian (1) Cellular *

Area CodePhone Number
Parent/Guardian (1) Home

Area CodePhone Number
Parent/Guardian (1) Work

Area CodePhone Number
Parent/Guardian (1) E-mail*
Parent/Guardian/Emergency Contact (2) Name

First NameLast Name
Parent/Guardian/Emergency Contact (2) Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian/Emergency Contact (2) Cellular

Area CodePhone Number
Parent/Guardian/Emergency Contact (2) Home

Area CodePhone Number
Parent/Guardian/Emergency Contact (2) Work

Area CodePhone Number
Parent/Guardian/Emergency Contact (2) E-mail
Medical
Please list any medical conditions or allergies that the coach should know
In case of emergency, every attempt will be made to reach the parent(s) listed above. If no one can be reached, I give permission for the Wappingers Crew Club to seek medical attention for the above named rower.
Parent/Guardian*

First NameLast Name
If under 18, Parent or legal Guardian Signature.*

Clear
To sign signature pad, use mouse and hold down button or for touch screens use pen or finger.
Policy Holder*

First NameLast Name
Policy #*
Insurance Company*
Payment
Cost of Learn To Row Program is $100.00. Payment is due on or before the first session. Please select preferred payment option. Cash, or Check made out to PO Box 221 Hopewell Junction, NY. If using Zelle, please put the athlete's name in the memo.

Check (Addressed to Wappingers Crew Club, bring to first practice)Zelle (wccreceiver@gmail.com)Cash (Bring to first practice)
Learn to Row Practice Schedule Selections

Learn to Row will be held at 2 practice locations: the HRRA Boathouse in Poughkeepsie and Sharpe Reservation in Fishkill. Each practice will have their own objective, and we will build off each practice the following week. The scheduling for the Boathouse will be different from the scheduling for Sharpe Reservation.
Athletes should attend one practice per day at the Boathouse. They can choose the practice they attend! Please select the shifts below you plan on attending so our coaching staff has an idea on numbers. Choose only one practice on Saturday 9/20 and one on Sunday 9/21.*

Saturday 9/20, 10a-12pSaturday 9/20, 12-2pSunday 9/21, 10a-12pSunday 9/21, 12-2p
Athletes will be assigned to 2 practices per week at Sharpe Reservation on Saturdays & Sundays from 9/27-10/12. We will do our best to accommodate schedules, but we have limited equipment. Please select ALL the practices you can attend. An email will be sent out shortly after registration closes with everyone's Sharpe Reservation shift assignments.*

Saturdays 8:30-10 AMSaturdays 10-11:30 AMFULL FOR 2025 - Sundays 8:30-10 AMFULL FOR 2025 - Sundays 10-11:30 AM
The last practice of Learn to Row be will at Sharpe Reservation on Sunday 10/19 from 8a-11a. All athletes can attend regardless of shift assignments.*

Acknowledge
Should be Empty:

Rower's Information

Parent/Guardian/Emergency Contact Information

Medical

Payment

Learn to Row Practice Schedule Selections