http://home.roadrunner.com/~rowaqueduct

2009 Membership Application

(Please Print)

Dues + this form + completed waiver are due in full by April 30, 2009

Name:_______________________________________Male___Female__

Address:____________________________________________________

City:____________________________________State:_______Zip:_____

Phone (Day/Work______________(Evenings/Home)_________________

Occupation: ________________ Birth Date ____/____/______

E-Mail: ____________________________

Type of Membership: _____Single ____Family ____ Learn-to Row

USRA# ________ Expiration Date: ____/____/____

MRA# ________ Expiration Date: ____/____/____

Rowing Interest: Sweep______ Scull _______

Please consider an optional contribution towards the purchase of a new Club shell (four or eight)

when submitting your annual Club dues.

* Submit one Application and Waiver for each family member and mail (the check) to:

Aqueduct Rowing Club, PO Box 202, Rexford, NY 12148-0202.

NOTE: Membership of persons under age 18 - individual or family – must be approved by the ARC

Board and must be sponsored by an adult member of the Aqueduct Rowing Club or a coach of a rowing

organization known to ARC. Prospective members under the age of 18 must demonstrate to the ARC

Board: personal responsibility, maturity, and good judgment. All members must adhere to the club

policy manual and demonstrate proficiency with the equipment before being permitted to use it

independently (without the permission of a coach).