Charlestown Adaptive Sailing Day Registration Form (WAITING LIST)--Sunday, September 10, 2017.
Welcome! AS OF AUGUST 23, THIS EVENT IS "SOLD OUT." YOU ARE MORE THAN WELCOME TO SIGN UP HERE, AND YOU'LL BE ADDED TO OUR WAITING LIST. WE WILL BE IN TOUCH THE WEEK BEFORE THE EVENT (AT THE LATEST) TO LET YOU KNOW IF A SPACE HAS OPENED UP. IT IS ESPECIALLY LIKELY THAT WE'LL HAVE SPACE FOR MORE SAILORS WHO USE WHEELCHAIRS ON LAND.

Please use this form to register for September 10 only. Please keep an eye on your email and make sure that jen@courageoussailing.org does not go to your spam folder. We'll be in touch the Wednesday before the sailing date with final sailing times.

How many people in your group want to sail?
If you're not sure, give us the most people who might possibly sail. There will be a chance to explain later. Typically, 4 adults (maybe 6 if there's a combination of kids and adults) is the maximum that can fit in one boat, likely fewer if members of your group use wheelchairs. We may not be able to supply more than 1 boat per group.
How many lunches would you like to order?
Lunches are usually sandwiches or wraps with meat and cheese, with a bottle of water and a cookie. A vegetarian option is available (select regular or vegetarian below), but unfortunately we can't meet other dietary restrictions.
Participant's name
Your answer
Participant's age
For adults, "adult" is all we need.
Your answer
Primary contact parent/guardian's name
If you're filling this out for yourself, please include your own contact information. If you represent a group home, please let us know here.
Your answer
Primary contact parent/guardian's email address
Your answer
Primary contact parent/guardian's cell phone number
If you don't have a cell phone, please include a home phone number.
Your answer
In addition to the participant, who else is sailing? Please list people who DO NOT live with any sort of disability here. Include first and last names and relationship to the participant.
Use this format: mom Tanya Smith, uncle George McDonald, sister Maria Smith, friend Mei Ling Yee, babysitter Michelle Reyes, aide Larissa Lee.
Your answer
In addition to the participant, who else is sailing? Please list people who DO live with any sort of disability here. Include first and last names and relationship to the participant.
Use this format: sister Maria Smith, friend Mei Ling Yee, housemate Jason Jones.
Your answer
Small groups or individuals may be combined in order to best accommodate as many participants as possible. Are you comfortable being paired with an additional adaptive sailor or small group?
Is there anybody your group would particularly like to sail with?
Your answer
What is your first choice of 1-hour sailing shift?
Final shift assignments will be made the week before the event. There may be an additional shift added from 11:30-12:30. We'll ask you about this later.
What is your second choice of 1-hour sailing shift?
If we added an 11:30-12:30 sailing shift, would this work for you?
Anything else we should know about scheduling? If you can be flexible, let us know. This is also the place to let us know about potential changes to the total number of people sailing.
Your answer
Primary contact parent/guardian's street address
Don't include the city/state/zip yet, please.
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
If the participant is a child, what school do they attend?
Your answer
What school system is this school in?
Your answer
Please indicate the type(s) of disability that you / your child / the participant lives with.
Please let us know more about the participant's (or participants') challenges and how we can help make this a great day of sailing.
If someone in your group will need physically adaptive equipment, you'll be asked to give us more specific information later.
Your answer
If you think that everyone in your group is able to go down a slanted ramp, get onto a boat, and sit without trunk support, you're done with this sign-up! Please skip the following questions and hit SUBMIT at the end. Otherwise, please continue.
Physically adaptive equipment used on land?
If you are answering for more than one participant, please list who uses what.
Your answer
Please indicate your / your child's / the participant's degree of trunk control.
Please indicate your / your child's / the participant's degree of RIGHT hand grasp strength.
Please indicate your / your child's / the participant's degree of LEFT hand grasp strength.
Any additional comments or suggestions?
If you've sailed a physically adaptive boat before and know what equipment works best, please let us know. If you are bringing a group with more than one person who will need physical accommodations, please describe the needs of each person.
Your answer
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