Rower Registration Once LAR receives your registration, you will be contacted and given access to the LAR MEMBERS page for scheduling your sessions. Rower Registration Name Name First First Last Last Street Address Apt., Suite, Etc. (Optional) City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Phone Email How did you hear about LAR? * Personal ConnectionSocial MediaWeb searchOther Who referred you to LAR? * Other: Please explain * Are you 18 years or older? * Yes No Parent/Legal Guardian Parent/Legal Guardian First First Last Last Parent/Legal Guardian Phone * Emergency Contact Name Emergency Contact Phone On a scale of 1-10, what would you consider your fitness level? Fitness level is not required, just a gauge of adaptations needed. On average, how many times a week do you exercise? Not at all 1-2 times 3-4 times More than 4 times What is your disability? * Please list any assistive devices you currently use. Are you able to transfer to the ground independently? * Yes No Can you float unassisted for 5 minutes? * Yes No Do you have a cardiac condition? Yes No Do you have any sensitivities to temperature? Yes No Use this space to give any medical information you wish us to know. Submit If you are human, leave this field blank. Skip back to main navigation