PYC Jr. Sailing 2020 Second or Subsequent Child Registration Form
Please only use the registration form below if you have already completed a full registration form. Make sure to use the same name and email address for the "Primary Parent" as you used in the original registration form. This will make it easier to match this one with the original registration record. When completed please download another set of these forms for the second or subsequent child's registration:
1. Participant’s Statement of Understanding and Parent’s Consent Form, and
2. Waiver of Liability, Assumption of Risk and Indemnity Agreement.
Note: if you compete the registration form below it is not necessary to download and fill out the "2020 Registration Form".

These forms are available at: https://poulsboyachtclub.org/page/junior-sailing-program#RegistrationForms

Then email scanned completed forms to JuniorSailing@PoulsboYC.org or mail them:
Poulsbo Yacht Club
Junior Sailing Program
18129 Fjord Drive N.E., Suite E
Poulsbo, Washington 98370

Call Patty Henderson at 360-447-8119 or Email to JuniorSailing@PoulsboYC.org for additional assistance.
Student First Name *
Enter Student's First Name
Your answer
Student Last Name *
Enter Student's Last Name
Your answer
Date of Birth *
Enter Student's Date of Birth
MM
/
DD
/
YYYY
Course Preference *
Please select the course week desired. Consult website for dates and types of courses.
Required
Student Email
Enter Student's Email Address
Your answer
Weight *
Enter Student's weight.
Your answer
Swim 50 Feet *
Can the student swim at least 50 feet?
Student Sailing Experience *
What prior sailing experience does the student have?
Your answer
Allergies *
Enter Student's Allergies to food, drugs or insects. If none please enter "None", otherwise, please describe:
Your answer
Physical Limitations - Chronic Ailments * *
*Does the student have any physical limitations or chronic ailments that might limit full participation in the program? If no please enter "NA", otherwise, please describe:
Your answer
Conditions or Concerns *
Are there any conditions or concerns you have regarding the student which our program staff should be apprised? If no please enter "NA", otherwise, please describe:
Your answer
Primary First Name *
Enter Primary Contact's First Name
Your answer
Primary Last Name *
Enter Primary Contact's Last Name
Your answer
Email *
Enter Primary Contact's Email Address
Your answer
Appropriate Fee *
Check the fee which applies. Payable before the beginning of desired course week.
Required
Textbook
Select desired number of textbook(s). Each textbook is $10.00.
T-Shirt(s)
Select desired number of T-Shirt(s). Each T-Shirt is $10.00.
None
One
Two
Three
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
Transmittal of Registration Forms *
I agree to complete and mail: 1. Participant’s Statement of Understanding and Parent’s Consent and 2. Waiver of Liability, Assumption of Risk and Indemnity Agreement. These forms are available at: https://poulsboyachtclub.org/page/junior-sailing-program#RegistrationForms Then mail the completed forms to: Poulsbo Yacht Club, Junior Sailing Program, 18129 Fjord Drive N.E., Suite E, Poulsbo, Washington 98370
Required
Statement of Safety & Payment *
*By checking "Yes" below you understand that we will take every precaution to keep students safe, but kids will be kids, and that you will keep us apprised of conditions we need to know in order to be prepared for potential situations. We will find a way to accommodate students who have special needs but we will need guidance from parents. I understand also that registration fees are required before the course begins.
Required
Data Collection *
I consent to the collection, storage, and use of my information by Poulsbo Yacht Club as described in the Privacy Policy located at: https://poulsboyachtclub.org/privacy-policy
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