Rochester Community Sailing Class On-Line Registration Form
Rochester Community Sailing Inc.
2050 Bay Shore Boulevard, Rochester NY 14622
Contact us at (585) 210-2380 or
Please complete and submit one form per participant.
Name of Participant
Birth Date of Participant
Name of Parent / Guardian if Participant is under 18 years of age
Emergency Contact Name, Phone Number and relationship to Participant
Does the Participant have any medical or other restrictions Rochester Community Sailing Instructors need to be aware of?
If YES, please describe below.
What class(es) are you registering for?
YOUTH BEGINNER, Week 1, July 8-12, 8:30 am to noon [$200 per student] ... SORRY THIS CLASS HAS BEEN CANCELLED DUE TO LACK OF REGISTRATIONS. PLEASE REGISTER FOR THE WEEK 2 JULY 15-19 YOUTH BEGINNER CLASS.
INTERMEDIATE, Week 1, July 8-12, 1-4:30 pm [$200 per student]
YOUTH BEGINNER, Week 2, July 15-19, 8:30 am to noon [$200 per student]
ADULT BEGINNER, Week 2, July 15-19, 1-4:30 pm [$200 per student]
INTERMEDIATE, Week 3, July 22-26, 8:30 am to noon [$200 per student]
RACING CLINIC, Week 3, July 22-26, 1-4:30 pm [$200 per student]
I have completed the on-line Liability and Photo Release form
My total Payment due is:
$200, 1 class
$400, 2 classes
$600, 3 classes
Select a Payment Method
On line payment via this link ...
Personal Check made out to Rochester Community Sailing and mailed to Rochester Community Sailing, c/o Jim Malecki, 37 Rawhide Drive, West Henrietta, NY 14586
How did you find out about Rochester Community Sailing?
RCS hardcopy Flyer
Kids out and about Website
WHAM Channel 13 Good Day Rochester Broadcast
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service