2025 Spring signupPlease complete this form by Friday, February 28 at 12:00pm. ATHLETE INFORMATION Athlete name * First Name Last Name Athlete date of birth * MM DD YYYY Athlete email * Athlete home address * Athlete grade * Freshman Sophomore Junior Senior Describe food allergies or sensitivities if any Athlete shirt size X-Small Small Medium Large X-Large XX-Large PARENT/GUARDIAN INFORMATION Parent/Guardian 1 name * First Name Last Name Parent/Guardian 1 phone * (###) ### #### Parent/Guardian 1 email * Parent/Guardian 1 home address * Parent/Guardian 2 name * First Name Last Name Parent/Guardian 2 phone * (###) ### #### Parent/Guardian 2 email * Parent/Guardian 2 home address EMERGENCY CONTACT INFORMATION Emergency contact 1 name * First Name Last Name Emergency contact 1 phone * (###) ### #### Emergency contact 2 name * First Name Last Name Emergency contact 2 phone * (###) ### #### HEALTH INFORMATION Athlete medical insurance plan * Policy number * Group number * Preferred Hospital * Please list any medical conditions your athlete has. * Please list any current medications your athlete takes. * If your athlete carries an inhaler, where is it kept? * If your athlete carries an EpiPen, where is it kept? * LOGISTIC INFORMATION Does your athlete need help coordinating a ride to and from practice? Yes No Would your athlete be willing to carpool athletes who need ride assistance? * Yes No SEASON INFORMATION How will Spring dues be paid? * Check mailed to PO Box Check (dropped off at boathouse) Zelle Quickbooks Would you like to pay Spring dues in two payments? (Feb 28 and Mar 28) * Yes, two payments No, pay in full RELEASE In signing this form I acknowledge that that the above information will be accessible to Rockford Rowing board members and coaching staff and that Rockford Rowing coaches and board members and Rockford Public Schools are not responsible or liable for any harm that may result from your athlete carpooling to or from practice or other team events. * Yes No Parent/Guardian 1 e-signature * Parent/Guardian 2 e-signature * Date signed * MM DD YYYY Thank you!
