Premier Sailing Young Sailor Registration Form 2021
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.
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Email *
Sailing weeks requested at The Tides Inn location *
Student's First Name *
Student's Last Name *
Age of student *
Name of parent *
Parents Phone numbers *
Name of Guardian during camp if different from above *
Contact numbers to be used during camp week - this is most important for emergency situations. *
Student's Home address: This is where we will mail your certificate in the Fall: Street Number *
Students address: City *
Students address; State and Zip Code *
Certificate Stage reached last year (if a returning student and if they can remember) eg. Stage 1, Stage 2 , Stage 3 etc.
Approximate weight of student (helps us to have appropriate boats ready)
Can he/she swim? *
Any medical information or emotional conditions that we should be aware for the safety/comfort of your child? *
Additional information or questions .Please use this space to write down anything you might like to add on any subject pertinent to this booking
How did you hear about us? *
Waiver including COVID 19 provisions
Waiver Sailing instruction waiver and release of liability and assumption of risk agreement: The undersigned Premier Sailing School customer/guardian assumes and understands that sailing is a potentially hazardous sport; that grounding, accidental jibes, man overboards, and equipment failures occur from time to time without warning, and that variations in wind and sea conditions, water traffic, submerged obstructions, and other hazards to navigation exist. In using Premier Sailing School’s equipment or participating in sailing instruction or sailing events at Premier Sailing School, the undersigned recognizes and accepts such dangers, and assumes full responsibility for such risks, and holds Premier Sailing School and /or their officers, employees, assistants, or agents harmless against any and all bodily injury, and/or property damages resulting from such risks. The undersigned expressly acknowledges that the New Tides LLC., RRYC, ICYCC, and and related parties have no responsibility whatsoever for sailing school activities. The undersigned gives permission for photos taken during the course to be used by the school for publicity/marketing. COVID 19: I affirm that I, as well as all of those living with me do not currently have, nor have experienced the symptoms of fever, fatigue, dry cough, difficulty breathing within the last 14 days. I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the last 30 days. I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the last 14 days.o I understand that Premier Sailing staff and director will not be held liable for any exposure to COVID-19 or any other contagion. *
A copy of your responses will be emailed to the address you provided.
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