Fort Langley Youth Rowing Society
ATHLETE PORTION

LEARN TO ROW (LTR) REGISTRATION FORM - Part 1

Please complete PART 1 and PART 2 to register your youth

Please provide all requested information to register for our Learn to Row session.

Program fees: $200.00 (includes Taxes and Rowing Canada/Rowing BC Membership Fees). $160.00 for 4 day week. Rowers who have completed a previous Learn to Row course receive 20% off. Receive 10% off your registration if you sign up 2 friends in the same week. Following completion of the Learn to Row session, youth are eligible to row for the remainder of the summer at a cost of $75 per week.

 RCA Membership: Rowing Canada Association (RCA) provides general liability and support services to rowing clubs in Canada. RCA fees are included in your Learn to Row fee.

Privacy Statement: All personal information given by participants will only be used for administration and regular communication with respect to the rowing programs. Your information will not be sold or given to anyone else with commercial intentions or otherwise.
Rowers Name Rower's Cell Rower's Email Rower's Birthday (DD MMM YYYY) First choice session dates Second choice session dates Third choice session dates Parent/Guardian #1 Parent/Guardian #1 Email Parent/Guardian #1 Cell Parent/Guardian #2 Parent/Guardian #2 Email Parent/Guardian #2 Cell Address City Postal Code Emergency Contact (not parent/guardian) Relationship to Emergency Contact Emergency Cell# Youth Care Card# Date of Last Tetanus Vaccine Family Dr Name and Telephone# List Allergies/Medical Conditions List medications taken regularily: List any physical Injuries or restrictions: Swimming Ability: (Youth must be able to confidently swim without a life jacket) Anything else to convey to Admin or Coaching Team?
I hereby give permission for the Fort Langley Youth Rowing Society to be responsible for providing medical supervision and treatment of my child if required.
Yes
No
Payment Method:
Rower's T-Shirt Size
Adult Small
Adult Medium
Adult Large
Submit
Legal Portion

CLUB REGISTRATION FORM - Part 2

Parent/Guardian please review the following documents:

ATHLETE WAIVER

RELEASE, WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

SAFETY CODE

PHOTO WAIVER
Parent/Guardian Name
ATHLETE WAIVER
I have read, understand and agree to abide by the Athlete Waiver
RELEASE, WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
I have read this Agreement. I fully understand its terms and that I have given up substantial rights by clicking this box. I intend it to be a complete and unconditional release of all liability.
SAFETY CODE
I have read, understand and agree to abide by the Fort Langley Youth Rowing Society Safety Code.
PHOTO WAIVER
By checking this box, I agree to the terms of the Photo Waiver.
I do not give Fort Langley Youth Rowing Society the authorization to use my child’s picture.
I, the parent and/or legal guardian named above, of the Minor Participant, understand the nature of rowing and the Rowing Activities and the Minor Participant’s experience and abilities. I believe that the Minor Participant is medically fit and able to participate in the Rowing Activities without limitation. I have read, understand and agree with the terms of the foregoing Agreement and will ensure that the Minor Participant fulfills the Participant’s obligations thereunder, and I HEREBY RELEASE AND FOREVER DISCHARGE THE RELEASEES and each of them from any and all liability, claims, demands and costs for any loss, damages, expenses or injury, including death, that the Minor Participant or any of the Minor Participant’s next-of-kin may suffer due, or alleged to be due, to any cause whatsoever, in whole or in part, including but not limited to negligence, breach of contract, breach of any statutory or other duty of care, including any duty under the Occupiers Liability Act, of the Releasees or any of them, and further including but not limited to failure on the part of the Releasees or any of them to safeguard and protect the Minor Participant from the Risks and the dangers of the Rowing Activities, and negligence in any rescue operations any of them may undertake. If, despite this Agreement, I, the Minor Participant, or anyone on the Minor Participant’s behalf makes a claim against the Releasees or any of them, I will indemnify, save and hold harmless the Releasees and each of them from any liability, claims, demands, loss, damages or costs which they or any of them may incur as a result of that claim.
I have read the above terms and, with clicking this box, agree to the terms set out above.
Submit