Adult / Women Only On-the-Water Sailing Lessons Registration Form
Complete this form to register for Adult Sailing or Women Only On-the-Water Sailing Lessons
Email address *
Name *
Your answer
Mailing Address *
Your answer
Home Phone *
Your answer
Work Phone *
Your answer
Cell Phone *
Your answer
Birthdate
MM
/
DD
/
YYYY
Previous Sailing Experience *
JPYC Member? *
Are you interested in becoming a JPYC member? *
Adult On-the-Water Sailing Lessons *
Women Only On-the-Water Sailing Lessons *
Cost *
I will pay *
WAIVER: I understand that there are inherent risks in participating in water sports. On behalf of myself and family, I do hereby voluntarily release, waive, discharge, hold harmless, covenant not to sue and to defend and indemnify the JPYC Foundation, its affiliates, agents, officers, employees, members, managers, instructors, volunteers, directors, representatives, successors and assigns (collectively “Released Parties”) from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services, attorneys’ fees or otherwise which may arise out of my employment in the JPYC Foundation's sailing programs and its affiliates' programs and use of their watercraft equipment and/or facilities (“Claims”). I understand that this release extends to claims of any nature and kind whatsoever, known or unknown, suspected or unsuspected, arising on and after execution hereof. I have read this form and fully understand that by signing this form, I am giving up certain legal rights and/or remedies. *
MEDIA RELEASE: I hereby give JPYC and the JPYC Foundation permission to use film, video tape and/or photographs of the above mentioned minor for lawful promotional or informational purposes. *
A copy of your responses will be emailed to the address you provided.
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