LEARN TO ROW PROGRAM
For St. Anthony's Students
2008 Application
Name
____________________________________________________Male_______Female________Address_________________________________________________ Date of Birth____/_____/_____
City____________________________________________ State __________Zip_________________
Telephone: ___________________ Height _________ Weight ___________
E-mail _____________________________ Rowing Experience ________________________________
T-shirt Size [ ] Small [ ] Medium [ ] Large [ ] X-Large
Donation is $175.00 per Session (Payable to St. Anthony’s Crew)
[ ] Session 1: August 4 - 8 ( 9:00AM - 12:00PM ) [ ] Session 2: August 4 - 8 ( 2:30PM - 5:30PM )
[ ] Session 3: August 11 - 15 ( 9:00AM - 12:00PM ) [ ] Session 4: August 11 - 15 ( 2:30PM - 5:30PM )
Parent/Guardian Information
Name
___________________________________________ Address ___________________________________City ______________________________State _______Zip __________ Day Time Phone: _________________
I certify that my son/daughter ______________________ is in good health. My son/daughter
will be able to participate in the physical activity required at the LEARN TO ROW
PROGRAM. LEARN TO ROW has my permission to provide emergency medical care in the
event of sickness or injury to my son/daughter.
Parent/Guardian Signature _____________________________ Date _______________________
Mail Application and Donation to: Saint Anthony’s Crew, C/O Learn-to-Row, P.O. BOX 20427, Huntington Station, NY 11746
Wavier and Health History must be sent in with Registration form.
Any questions? Please e-mail us at: StAnthonyCrew@gmail.com