EAST END ROWING MEMBERSHIP APPLICATION

Name: ______________________________________Application Date ____________________

Address:________________________________ City/State___________________Zip:________

Phone: Home:__________________ Office: _________________

Email address:______________________ Birth Date: ______________ USRA # ____________

Profession: _____________________Other Skills/Interests:______________________________

TYPE OF MEMBERSHIP

Club _______ Age 19 or older. Access to all rowing club equipment. Eligible to vote for and be elected as an Officer of the Club. Yearly dues $150

Junior_______ Ages 13-19. Participate in organized practices only. No voting privileges. Program fees vary.

EAST END ROWING NEEDS YOUR HELP TO MAKE THE CLUB RUN. PLEASE CIRCLE THE COMMITTEES THAT ARE
OF MOST INTEREST TO YOU.

Membership Building and Grounds Fundraising Equipment Newsletter/Website

I agree to abide by the Club constitution and other club rules and regulation. I understand that to row out of the Club I
must be a member of both East End Rowing.  I will contribute to the management, maintenance, or repair of the club facilities and equipment. I understand that rowing can be a vigorous sport, with implicit hazards for all participants. I certify that I am in good cardiovascular health and have received approval from my doctor to participate in rowing activities. I also certify that I can swim at least one-quarter mile and tread water fully clothed for ten minutes.

Signed: ___________________________________ Date: ______________

Parent/Guardian :_________________________________ Date: ______________

Print name: ________________________________________


MAKE CHECKS PAYABLE TO EAST END ROWING
Mail to Membership Committee PO Box 1192 Flanders, NY 11901

Please print USROWING WAIVER and mail in with application.