Coach/Cox Enrollment

The sport of rowing poses significant risks to the participant. The risks include, but are not limited to: unexpected immersion into cold water as a result of a boat flipping, collisions with other boats, docks or objects in the water, being involuntarily removed from a boat as a result of an oar’s momentum (“crabbing”), falling off docks, changing weather conditions, or other injuries sustained while rowing, moving heavy equipment, entering or exiting the boat, docking, or any related rowing activities.

Rochester Boat Club

* = Required items.

Enrollment
Are you new to RBC? *
If new, how did you hear about RBC?
Name: Name: * First Last
Nickname

If you prefer to go by a nickname, please enter it here.
Gender

Not required. Needed for regatta boating.
Date of Birth Date of Birth * / MM / DD YYYY
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
US Rowing Number

Now that US Rowing requires all rowers to sign their waiver electronically (insurance underwriter requirement), this requires all US rowers to be members of US Rowing (applies to all US clubs). If you forgot your US rowing number you can look it up at the US Rowing website.
Preferred Phone: Preferred Phone: * - ### - ### ####

We would prefer a cell phone number as this is the number we will call if you are late for boating.
Share my phone number with registered rowers

Note: coach phone numbers will be shared by default, cox phone numbers will not.
Preferred Email: *
Google Account Email

RBC uses Google services such as Google Sheets and in order for us to share information with you, we require you to have a Google account (not necessarily a Google email address). If your Google account login email is the same as your preferred email, just enter it again here. You will have an opportunity to provide this later if you don't have a Google account.
Share my email with other registered rowers
Tell us about yourself (hobbies, occupation, etc)
Share my hobbies / interests with other registered rowers
Medical and Emergency Info
Do you have any past or present medical issues that could affect your ability to coach/cox? *
If Yes, please describe
In case of emergency, who should be contacted? In case of emergency, who should be contacted? * First Last
Emergency Contact Phone Emergency Contact Phone * - ### - ### ####
Relationship to rower *
Waiver
Please check each box to acknowledge. *

Please check each box to acknowledge. Release of Liability
I hereby assume all risks for personal injury and property, losses and damage, which may arise from my participation in the sport of rowing; and for myself, my heirs, administrators, and assigns; hereby release Rochester Boat Club (RBC) and its representatives, coaches and other individuals assisting in the programs, their successors, assigns, and duly appointed agents, from any and all claims, which may arise from injury, losses and damages of whatever nature sustained by me in connection with such participation.
Emergency Medical Treatment
I hereby attest that I have full knowledge of the risks involved in this participation, which I assume and will pay my own medical & emergency expenses in the event of accident or injury, regardless of whether I have authorized such expenses.
Safety Video
I have viewed the US Rowing Safety Video, understand the safety protocols and will observe safe practices at all times while participating in the sport of rowing.
Code of Conduct
I have read the Rochester Boat Club Code of Conduct on the RBC website. I agree to abide by all rules for participation and to the expectations contained therein regarding respect for others, fairness and safe practices.
Swimming Competency
I hereby certify that I am a competent swimmer, capable of swimming 100 yards, treading water for 10 minutes and able to put a life jacket on while in the water.
Signature

.
Draw your signature into the box below.
If under 18, a parent or guardian must sign instead. *

Clear
Use your finger on a mobile device/tablet or mouse with a computer.
Date: Date: / MM / DD YYYY

Coach/Cox Enrollment

Coach/Cox Enrollment

Enrollment

Medical and Emergency Info

Waiver

Signature