2025 AARC Adaptive Rowing Initial Intake 
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Email *
Athletes Name *
First and Last Name 
Age/Gender *
Date of Birth ( must be before 6.1.2007) *
Parent/Guardian  *
Emergency Contact Name & Phone and email *
Does the participant have a legal guardian or legal representative? If YES, the participant's legal guardian or legal representative must sign the waiver & release liability agreement on behalf of the participant.  *
Disability Evaluation: Please check all that apply. *
Required
What assistive devices do you use? ( ex: splints, crutches, wheelchair, cane)
Please let us know if you have any of the following issues that may affect your ability to safely row. Please check all that apply:  *
Required
Are you sensitive to heat or cold? Please describe your reaction.
Are there any difficulties/issues with hearing or vision?
Please use this space to add conditions not listed above, or further information about items listed. 
Height & Weight *
Are you (the athlete) able to enter a boat or the barge with no or very minor assistance?  *
Are you (the athlete) able to stand up and exit a boat or the barge with no or very minor assistance?   *
How many days/week do you currently exercise? 
(0-7 days)
 *
What are your goals for participation?
I LOVE when a coach/teacher/person........... (fill in the blank) *
I REALLY DISLIKE when a  coach/teacher/person........... (fill in the blank) *
Is there any other information we should know to make this a great experience for you, or to make sure coaches are ready on the first day for any adaptations you may have or will need? *
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