PENINSULA AQUATIC CENTER JUNIOR CREW
Membership Application
Rower's Info
Name __________________________________________________ Address ________________________________________________ City ________________________ Zip code ____________________ Home Phone # _____________ Alternate Number _______________ School ______________________Year of Graduation ____________ Ht. ________ Wt. ___________ Date of Birth ____________ Email address _______________________________Parent's Info
Name _____________________________________________________ Address ___________________________________________________ City _______________________________ Zip code ________________ Home Phone ___________________ Work Phone _________________ Email address ______________________________________________ Website Address (only for self-business) _________________________Do you have access to a computer to check the website for updates or for weekly emails? _______________
Please hand in to your coach or mail to:
PACJC P.O. Box 669 RWC, CA 94064