Health Form

2024

COVID 19 Information
The health and safety of our Crew and staff is of upmost importance and it is for that reason ALL crew and staff are: 1. Required to have COVID vaccinations before joining any training or practice. 2. Will be asked to sanitize their hands prior to training or practice. 3. Notify the Coach & follow Monroe County Health Department recommendations if they have been exposed to a COVID positive individual.
Rowers Name Rowers Name First Last
Emergency Contact Emergency Contact First Last
Emergency Contact phone # Emergency Contact phone # - ### - ### ####
Relationship to Rower
Swimming Level

Swimming Level I am am a competent swimmer I can tread water I never learned to swim
ROWING IS A VERY STRENUOUS ACTIVITY
If you have any concerns about your physical capacity to row please discuss with your oncologist/radiologist/PCP to get recommendations and clearance to row.
MEDICAL HISTORY IS CONFIDENTIAL INFORMATION
Please discuss with the Coach medical concerns that may be impacted by rowing. diabetes, cardiac conditions, neurologic conditions or severe allergic reactions. *Inform the Coach if you are medically required to carry medications such as an inhaler, Epi Pen, glucose tabs or cardiac medication.
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