Girls Row Stockton Registration -- Fall 2021
Thank you for registering for Girls Row Stockton Fall 2021 Season. This is a 4x/week competitive program open to girls in the 8th-12th grades.

Please fill out the form to register. This form should be filled out by a parent/guardian.

Program Dates: August 16 -- November 19 (1 week break TBD)
Day/Time: Monday, Tuesday, Thursday 4:00-6:30 PM, Choice of Wednesday or Friday 4:00-6:30 PM
Program Fee: $625
*Full and partial financial aid will be available, along with payment plans. We want this program to be accessible to ALL athletes regardless of financial circumstances. Please email Coach Jane ( for the financial aid application form.
Important Dates: Head of the Port Regatta, October 10-11

Delta Sculling Center
4950 Buckley Cove Way
Stockton, CA 95219

If you have any questions, please feel free to contact Coach Jane McClellan at 978-831-7797.
Sign in to Google to save your progress. Learn more
Athlete Personal Information
First Name *
Last Name *
Home/Mailing Address (Please include Zip Code) *
Athlete Phone Number *
Athlete Email Address *
Current School *
Current Grade (as of Aug 2021) *
Date of Birth *
Approximate Height and Weight *
Water Safety Information
We are asking these questions to determine your child's safety in and around water and whether they will need to wear a PFD while rowing. All athletes will have the option of wearing a PFD if it increases their comfort in the boat.
Is your child... *
Unsure to swim one length of the pool (25 yards) without help? to tread water for 5 minutes? to swim under water without fear?
...comfortable swimming in deep water?
...comfortable swimming in dark water (i.e. in a lake or river)?
I understand that athletes who do NOT have adequate water safety skills will be required to wear a PFD while in the boat or on the dock. *
Health Information
Please let us know anything about your child's health that may impact their safe participation in rowing.
Does your child have any health needs we need to be aware of? (For example, allergies, medications, injuries, medical condition, etc.) If yes, please describe. *
Does your child have any behavioral or developmental needs which would require us to modify the learning environment? If yes, please describe. *
Parent/Guardian Information
Please fill out the contact information for at least one parent or guardian with whom coaches will be in regular contact.
Parent/Guardian 1 -- Full Name *
Parent/Guardian 1 -- Phone Number *
Parent/Guardian 1 -- Email Address *
Parent/Guardian 1 -- Home Address (if different from the athlete's)
Parent/Guardian 2 -- Full Name
Parent/Guardian 2 -- Phone Number
Parent/Guardian 2 -- Email Address
Parent/Guardian 2 -- Home Address (if different from the athlete's)
Emergency Contact Information
Please list at least one person we can contact in case an emergency arises and the primary guardian is unreachable.
Emergency Contact Name *
Relationship to Athlete *
Phone Number *
Acknowledgment of Risk
To be completed by parent or guardian if athlete is under 18: The sport of rowing poses significant risks to the participant because most activities occur in, on, or around water. These risks include, but are not limited to, expected and unexpected immersion into swift and/or cold water as a result of a boat flipping, collisions with other boats, being unintentionally removed from a boat as a result of an oar’s momentum (“crabbing”), falling off of a dock, authorized and unauthorized swimming, changing weather conditions or other occurrences. I hereby grant permission for the above-named athlete to participate in all rowing activities, both on land and on water, conducted by Delta Sculling Center beginning August 1 through December 31, 2021.
I agree to the above and grant my permission. *
Publicity Release
Delta Sculling Center has permission to use any and all photographs and video taken of me and my family and to include our name(s) in materials that promote the programs, services, and events of Delta Sculling Center without payment or notification.

I understand that all prints, video, and negatives become sole property of Delta Sculling Center and may be used by Delta Sculling Center without payment or notification. I understand usage may include broadcast, print, or online news coverage, including social media.
I agree to the above and consent. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy