Northeast Rowing Center
2010 Application Form

Print, Complete Form and Mail with $300 Deposit Check
Fee $900 per Session (includes instruction, room & board)

  Registration    or      Standby (do not include deposit)

  Rowing 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                                             2010
        completed 2nd year                                            2011
        completed 3rd year                                             2012
        other ____________                                        2013
                                                                                           other ______

Goals  (Briefly explain what you wish to accomplish at the Center):

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

A deposit of $300 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 $300 Deposit Check - Thanks
P.O. Box 2060 · Duxbury MA 02331
Tel. 781-934-6192 ·  email@RowCamp.com

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