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Premier Sailing Young Sailor Registration Form 2020
Once you have completed this form and paid for your sailing course, we will send you a confirmation. Payment is by check to Premier Sailing, PO Box 779, Irvington, VA 22480, or call with credit card number.
Email address *
Sailing weeks requested at The Tides Inn location *
Required
Student's First Name *
Your answer
Student's Last Name *
Your answer
Age of student *
Your answer
Name of parent *
Your answer
Parents Phone numbers *
Required
Name of Guardian during camp if different from above *
Your answer
Contact numbers to be used during camp week - this is most important for emergency situations. *
Your answer
Student's Home address: Street Number *
Your answer
Students address: City *
Your answer
Students address; State and Zip Code *
Your answer
Certificate Stage reached last year (if a returning student and if they can remember) eg. Stage 1, Stage 2 , Stage 3 etc.
Your answer
Approximate weight of student (helps us to have appropriate boats ready)
Your answer
Can he/she swim? *
Your answer
Any medical information or emotional conditions that we should be aware for the safety/comfort of your child? *
Your answer
Additional information or questions .Please use this space to write down anything you might like to add on any subject pertinent to this booking
Your answer
How did you hear about us? *
Required
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