Northeast Rowing Center
2012 Application Form
Print, Complete Form
and Mail
with $350 Deposit Check
Session 1 / August 18-24 (Rowing &
Coxing) - Fee $975 per
Session 2 / August 25-28 (Sculling & Coxing) - Fee $650
per
Fee includes instruction, room & board
Registration or
Standby (do not include deposit)
Session 1 (Rowing & Coxing) - Fee $975 Session 2 (Sculling & Coxing) - $650
Rowing Program: or
Coxing Program
Sculling Program: or
Coxing Program
Port side
Starboard side
Either (but prefer ___________)
Male,
Female Have you attended Northeast before?
Yes,
No
Name _________________________________________________________
Address _________________________________________________________
City ___________________________ State ______ Zip ______________
Home tel. (______) _______-__________ Work/School (______) _______-__________
Email ________________________________________________
Birth date _____/_____/19_____ Height ____ ft. _____ in. Weight _________lb.
Transportation:Air,
Auto,
Undecided T-Shirt size:
S,
M,
L,
XL,
2XL
Experience & Goals
School and/or Club Name: ________________________________________
Experience (at time of camp): Grad. year:
completed 1st year
2012
completed 2nd year
2013
completed 3rd year
2014
other ____________
2015
other ______
Goals (Briefly explain what you wish to accomplish at the Center):
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________A deposit of $350 required with registration.
· Registrations are accepted on a space available basis.
· Cancellations before June 1st are refundable and subject to a $50 cancellation fee.
Cancellations after June 1st are non-refundable.
· Balance is due June 1st.Signed ______________________________________ Date _____________
Print, Complete Form
and Mail
with $350 Deposit Check - Thanks
P.O. Box 1551, Hightstown, NJ 08520
Tel. 609-712-2667 · bgrudt@RowCamp.com