2017 QYC Youth Sailing Program Registration Form
Please complete the Registration form below. If registering more than one child, you will need to complete one form per child. When finished, click "Submit". An invoice will then be emailed to you along with instructions on completing required forms.


Payments will be due no later than May 15, 2017.

Student Last Name
Your answer
Student First Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Height
The student's height and weight are used together with their experience level to place them into an appropriate boat.
Your answer
Weight
Your answer
Entering Grade
Your answer
School
Your answer
Does the student have previous sailing experience? If yes, please describe briefly.
Your answer
Parent or Guardian name
Your answer
Address
Your answer
City
Your answer
ZIP Code
Your answer
Home Phone
Your answer
Daytime Phone
Your answer
Cell Phone
Your answer
E-mail
We use email as a way to communicate; please provide an address that a parent/guardian checks regularly..
Your answer
How did you hear about us?
Help us spend our limited marketing budget wisely
Sailing Program Desired Session(s)
Cost per two-week session is $575 for members of QYC / $635 for non-members. (S1 prorated due to July 4th)
Try-It Program Desired Session
Only for first-time beginners under the age of 12. Cost per one-week session is $320 for members of QYC / $350 for non-members.
Do you want to be in class with someone else? Please enter their name.
We cannot guarantee that students will be placed together, but we will do our best.
Your answer
Racing Program Desired Session(s)
Cost per four-week session is $1175 for members of QYC / $1300 for non-members. (R1 prorated for July 4th holiday)
Any additional comments or requests?
Your answer
Were you referred by a friend? If so, please share the student's name so we can give them their referral bonus!
Your answer
Are you a member of QYC?
Members receive a discounted tuition rate.
Submit
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