MIDDLE SCHOOL DEVELOPMENT TEAM REGISTRATION

Athlete's Name

First Name

Last Name

Athlete's Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Athlete's Email Address

Athlete's Birthdate

MM

DD

YYYY

Athlete's Height

Athlete's Weight

Gender

Male

Female

School District

Grade

Parent/Guardian #1 Name

First Name

Last Name

Parent/Guardian #1 Cell Phone

Country

(###)

###

####

Parent/Guardian #1 E-Mail Address

Parent/Guardian #2 Name

First Name

Last Name

Parent/Guardian #2 Cell Phone

(###)

###

####

Parent/Guardian #2 E-Mail Address

Checks should be made payable to Pittsburgh Rowing Club and mailed to 929 Howden St., Pittsburgh, PA 15202. Completed forms must be submitted on or before the first day of practice..