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INDIANA ROWING CAMP

2014 INDIANA ROWING CAMP

June 22-26
Indiana University
Bloomington, Indiana

CAMP COSTS

$810.00 Overnight/$685.00 Commuter

* Commuter rate includes lunch and dinner, stay until after evening activity is completed

FOR REGISTRATION INFORMATION:

Registration Dates: Until camp fills or June 18

Phone: 1-812-856-5774
E-Mail: Click Here!
Register On-Line: Now Available!
Download Camp Brochure: Click Here!


If Mailing in registration, send to:
Indiana Rowing Camp
Assembly Hall
1001 E. 17th Street
Bloomington, IN 47408

All IU Camps are open to all and any entrants




2014 Indiana Rowing Camp

Registration Note: Registrations will be accepted until the camp is full or until June 18. All cancellations must be in writing. It can be faxed to 812-856-5116 or emailed to IURowing@Indiana.edu. For cancellations prior to June 14, all fees will be refunded except for a $200 administrative fee. For cancellations occurring from June 14-21, 50% of fees will be refunded. Day of camp or during camp cancellation, no refund. Registration fee/deposit is non-refundable and non-transferable.
 
Housing Option *
 Overnight
 Commuter
 
Camper's Last Name*
 
Camper's First Name*
 
Home Address*
 
City*
 
State*
 
Zip*
 
Parent/Guardian Name(s)*
 
Camper's Home Phone #*
 
Parent's Cell Phone #*
 
Parent's E-Mail Address*
 
Grade Entering (Fall 2014)
 
Camper's School*
 
Height
 
Weight
 
Please Indicate*
 Port
 Starboard
 Sculler
 Coxswain
 Unknown
 
Briefly describe your rowing experience, if any*
 
Roommate Preference
 
How did you hear about Hoosier Rowing Camp?*
 Hoosiersportscamps.com
 Row2K.com
 Club Team/Coach (please fill in name below)
 Friend (please write in name below)
 Camp Brochure
 Other (please provide details below)
 
Additional details on how you heard about Hoosier Rowing Camp
 
T-Shirt Size (adult sizes)*
 S
 M
 L
 XL
 XXL
 

PARENTAL CONSENT FORM

In order to enable health facilities in Bloomington to provide prompt care to your daughter, please read and complete this Consent Form. This will enable us to help your child without delay in the event of an emergency. NOTE: Please complete EVERY field on the medical/parental consent form!  

Name of Minor*
 
Social Security # (if used by insurance)
 
Birthdate (Month/Day/Year)*
 
Insurance Company*
 
Policy Number/Group #*
 
Name of policy holder*
 
Primary Physician - Name and Phone #
 
Present Medication (include dosage)
 
Allergies
 
Date of Last Tetanus Toxoid
 
Emergency Contact (Name and Phone #)*
 

* I grant permission to the Directors, Assistants, or other persons responsible for her care to act on my behalf for said minor in granting permission for evaluation and treatment of medical problems. I understand that should a major medical problem arise, an attempt will be made to notify me by telephone. In the event that I cannot be reached, I hereby give my consent to such medical treatment as deemed necessary, including surgery, x-ray examinations and anesthesia to be rendered to said minor by a licensed physician or nurse.  

* My child can swim and is competent in the water.  

* I authorize the Indiana Rowing Camp to photograph my child in camp activities for promotional purposes.  

* By my submission of this registration, I represent that I am either 18 years of age or older, or that I am the parent or legal guardian of the registrant (if he/she is under age 18). I represent I have read the terms of the Privacy Policy, that I understand the manner in which the information collected about the registrant may be used, and that I agree to the use of the registrant’s personally identifiable information in the manner described in the Privacy Policy.  

* WAIVER In consideration of being allowed to participate in the Indiana Rowing Camp, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge and covenant not to sue Indiana Rowing Camp, Forward Marketing LLC, its officers, employees and agents for liability from any and all claims including the negligence of the Indiana Rowing Camp, its officers, employees and agents, resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in the Indiana Rowing Camps.  

Parent/Guardian Name*
 
Date*
 
PAYMENT OPTIONS
Please select your payment option by indicating a '1' in the quantity field.
We need a registration form and consents completed for each participant.

Note: A charge from Hoosiersportscamps.com will appear on your credit card for your on-line registration. However, if any of the Indiana Rowing Camps are canceled for any reason, refunds must be collected directly from Indiana Rowing Camp, 1001 E. 17th Street, Bloomington, IN 47408. Phone 812-856-5774.

 
Qty 
 $200.00 Option 1 - Deposit (note: remaining camp dues will be charged to same credit card approximately two weeks before the start of camp)

 $810.00 Option 2 - Overnight Camer - Payment in Full

 $685.00 Option 3 - Commuter Camper - Payment in Full