Adult Dinghy Course
Carrickfergus Sailing Club - Sailing Course Registration Form.
Senior Instructor : Andrew Penney
Dinghy Instructor : TBA
Cost : £80 Member / £120 Non Member

Please fill out one form for each participant.

We can not confirm your place on the course until payment is made.

Email address *
Which course would you like to participate in? *
Name *
Your answer
Address *
Your answer
Date Of Birth *
MM
/
DD
/
YYYY
Sex *
Daytime Telephone *
Your answer
Emergency Contact Number *
Your answer
CSC Member *
Does the participant suffer from any medical conditions that we should be aware of? *
Is the participant taking any medication we should be aware of? *
Does the participant have any injuries present? *
If the answer is yes to any of the above, please give details.
Your answer
It is your responsibility to make known to us any medical conditions that may affect the participants safety during the course.
Do you give permission for photographs / video images to be taken of the participant for the use on club website / social media / publications?
Describe the participants previous sailing knowledge.
Your answer
A copy of your responses will be emailed to the address you provided.
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