Registration for PACC Learn to Row Clinics
Sign in to Google to save your progress. Learn more
Email *
What is the student's first name? *
What is the student's last name? *
What is the student's cell phone number, including area code, if applicable? (Please use ###-###-#### format.)
May we text the student at this number (if applicable)?
Clear selection
Has the student ever rowed before? Please answer "Yes" or "No" below. If yes, please state where and when. *
What is the student's date of birth? *
MM
/
DD
/
YYYY
What grade will the student be in during the 2025-2026 school year? *
What is the student's primary home address, including the city and zip code? *
When is the student available? *
You must provide emergency contact information for 2  parents/guardians. What is the 1st parent's/guardian's first & last name? *
What is the 1st parent's/guardian's cell phone number? (Please use ###-###-#### format.) *
May we text parent/guardian #1 at this number? *
What is the 1st parent's/guardian's email address? *
 What is the 2nd parent's/guardian's first & last name? *
What is the 2nd parent's/guardian's cell phone number? (Please use ###-###-#### format.) *
May we text parent/guardian #2 at this number? *
What is the 2nd parent's/guardian's email address? *
Each student rower will need to sign a  USRowing waiver that provides insurance coverage in order to attend this clinic, this information will be provided separately. *
In the event of inclement weather, which could jeopardize the safety of the student rowers as well as our coach, a clinic may have to be cancelled.  The $10 registration fee can be reimbursed,  *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms