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.
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