ROC City Sailing Class On-Line Registration Form
ROC City Sailing Inc.
2050 Bay Shore Boulevard, Rochester NY 14622
Contact us at (585) 210-3225 or info@roccitysailing.org

Please complete and submit one form per participant.
Email address *
First Name of Participant *
Last Name of Participant *
Birth Date of Participant *
MM
/
DD
/
YYYY
Name of Parent / Guardian if Participant is under 18 years of age
Mailing Address *
Phone Number *
Emergency Contact Name, Phone Number and relationship to Participant *
Does the Participant have any medical or other restrictions ROC City Sailing Instructors need to be aware of? *
If YES, please describe below.
What class(es) are you registering for? *
Required
LIABILITY WAIVER: In consideration of being allowed to participate in the Roc City Sailing (RCS) activities, events, and services, I, the undersigned, acknowledge, appreciate, and agree via the checkboxes below that: *
Required
PHOTO / VIDEO RELEASE *
HEALTH AND SAFETY PRE-SCREENING FORM (go to the RCS registration page for a copy of the form) *
How did you find out about ROC City Sailing? *
A copy of your responses will be emailed to the address you provided.
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