2019 Spring Season Non Member Registration
Ahoy!

Thank you for choosing to enroll your child in the Coconut Grove Sailing Club Instructional Programs. Please take the time to look through the Registration Form and fill it out in its entirety, as this information is very important to us for making sure your child has a great time here in Coconut Grove, FL. See you out on the water!

Respectfully yours,

Lauren Simpson
General Manager, CGSC

REFUND/CANCELLATION POLICY: In the event that you must cancel your reservation, you will receive a refund for the total amount of registration minus a non-refundable $100 registration fee. Cancellation notice must be submitted in writing. Requests for cancellation due to illness or accident require a physician’s written verification and will receive a full refund.
BOAT STORAGE POLICY: In order to store a personal boat on CGSC property, the owner must be a member (Regular, Associate, Junior) of Coconut Grove Sailing Club. There is a $10 dollar monthly fee associated with this service, please refer to the official membership application for more information.
LATE REGISTRATION: If you submit registration after 10 AM January 13th, you will be assessed a $25 late registration fee per registration. It is important to us to receive your registration in a timely manner so that we may better serve you and your sailor(s).
Email address *
First & Last Name of Child *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Height *
Returning Sailor? *
Parents Names *
Your answer
Parents Phone Numbers *
Your answer
Parents Email Address *
Your answer
Parents Home Address *
Your answer
List of Known Allergies *
Your answer
List of Prescribed Medications *
Your answer
Any other medical conditions we should be aware of? *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Name of Authorized Person for Pick Up *
Your answer
Phone Number of Authorized Person for Pick Up *
Your answer
Choose your Program *
Authorizations and Disclosures
I hereby authorize my child to participate in the Coconut Grove Sailing Club Instructional Center, Inc. Sailing Program.

In consideration of the Coconut Grove Sailing Club Instructional Center, Inc. a not-for-profit 501(c)3 Florida Corporation, providing sailing instruction to my child, I hereby release, acquit, and discharge the Coconut Grove Sailing Club, Inc. its successors and assigns, its employees, agents, members, volunteers, officers and directors from all claims, demands, actions, causes of action, damages, injuries and cost of any nature or kind whether property, personal injury or bodily injury or any other type of injury or damage that may arise from my child’s participation in the sailing program as well as use of the facilities of the Club, and its equipment. This release is on my behalf as the parent or legal guardian and on behalf of my child and any person claiming through my child.

I understand the risks inherent in the sport of sailing and in water sports in general, and in any activity involving children. I attest that my participating child has had swimming instructions and is capable of treading water for five minutes, swimming 25 meters with good form and easy breathing (any swimming stroke) and demonstrates the capacity to alternate floating and treading water for an unlimited period of time. I understand that these skills may help reduce the risks but cannot eliminate them.

I also attest that my participating child is free and unencumbered from any physical or mental impairment and is free of any contagious or infectious disease that might interfere with his or her health or safety during this program.
I hereby grant Coconut Grove Sailing Club Instructional Center, Inc. and its related companies to take, copyright, use, publish, alter, and distribute photographs, movies, films, videotapes, audiotapes, and any other recording of the child. I further irrevocably consent to the worldwide use of the child’s name and voice likeness. I understand that such use may include publicity, advertising, promotion, or any other lawful purpose, without restrictions or remunerations.
I give authorization to the CGSCIC for treatment in the event of any accident or injury if I cannot be reached. I have read and attest that the above is true and correct.
Do you agree to these terms and conditions? *
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.