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 info@rochestercommunitysailing.org

Please complete and submit one form per participant.
Email address *
Name of Participant *
Your answer
Birth Date of Participant *
MM
/
DD
/
YYYY
Name of Parent / Guardian if Participant is under 18 years of age
Your answer
Mailing Address *
Your answer
Phone Number *
Your answer
Emergency Contact Name, Phone Number and relationship to Participant *
Your answer
Does the Participant have any medical or other restrictions Rochester Community Sailing Instructors need to be aware of? *
If YES, please describe below.
Your answer
What class(es) are you registering for? *
Required
I have completed the on-line Liability and Photo Release form *
My total Payment due is: *
Required
Select a Payment Method *
How did you find out about Rochester Community Sailing? *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy