Northeast Rowing Center
2008 Application Form

Print, Complete Form and Mail with $250 Deposit Check

Fee $875 per Session (includes instruction, room & board)

bopx1box.gif (117 bytes)  Registration    or    bopx1box.gif (117 bytes)  Standby (do not include deposit)

bopx1box.gif (117 bytes)  Session 1  (Aug. 16-22)    and/or    bopx1box.gif (117 bytes)  Session 2 (Aug. 23-29)

bopx1box.gif (117 bytes)  Rowing Program:         or        bopx1box.gif (117 bytes)  Coxing Program   
            bopx1box.gif (117 bytes)  Port side
            bopx1box.gif (117 bytes)  Starboard side
            bopx1box.gif (117 bytes)  Either (but prefer ___________)

bopx1box.gif (117 bytes)  Male,    bopx1box.gif (117 bytes)  Female                        Have you attended Northeast before?   bopx1box.gif (117 bytes) Yes,      bopx1box.gif (117 bytes) No

Name     _________________________________________________________

Address _________________________________________________________

       City ___________________________ State ______  Zip
______________

Home tel.  (______) _______-__________      Work/School  (______) _______-__________

Email   ________________________________________________

Birth date   _____/_____/19_____         Height   ____ ft.  _____ in.       Weight   _________lb.

Transportation:
bopx1box.gif (117 bytes) Air,  bopx1box.gif (117 bytes) Auto,  bopx1box.gif (117 bytes) Undecided           T-Shirt size: bopx1box.gif (117 bytes) S,  bopx1box.gif (117 bytes) M,  bopx1box.gif (117 bytes) L,  bopx1box.gif (117 bytes) XL,  bopx1box.gif (117 bytes) XXL

Experience & Goals

School and/or Club Name:  ________________________________________

Experience (at time of camp):                                Grad. year:
        bopx1box.gif (117 bytes)
completed 1st year                                             bopx1box.gif (117 bytes) 2008
        bopx1box.gif (117 bytes) completed 2nd year                                            bopx1box.gif (117 bytes) 2009
        bopx1box.gif (117 bytes) completed 3rd year                                             bopx1box.gif (117 bytes) 2010
        bopx1box.gif (117 bytes) other ____________                                        bopx1box.gif (117 bytes) 2011
                                                                                           bopx1box.gif (117 bytes) other ______

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

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

A deposit of $250 required with registration.
       
·  Registrations are accepted on a space available basis.
       
·  Cancellations before June 1st are refundable and subject to a $40 cancellation fee.
           Cancellations after June 1st are non-refundable.
       
·  Balance is due June 1st.

Signed  ______________________________________   Date  _____________

Print, Complete Form and Mail with $250 Deposit Check - Thanks
P.O. Box 2060 · Duxbury MA 02331
Tel. 781-934-6192 · Fax 781-934-5350 · email@RowCamp.com

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