Indian Creek Yacht & Country Club Summer Camp Registration Form 2019
Join in the fun this summer - Register Now Open
Email address *
First Name of Camper *
Your answer
Last Name of Camper *
Your answer
Age (As of 1/1/2019) *
Your answer
Weight *
Your answer
T Shirt Size *
Name of Parent/Guardian *
Your answer
Best Phone Number to Reach You During Camp *
Your answer
Home Address
Your answer
Name of Guardian During Camp *
Your answer
Additional Contacts During Camp (Optional) - Please include a phone number
Your answer
One Child $380
More than One $345

Non-Member $445 First Week
$395 Additional Weeks

Sailing Camp Selection
9 AM to 12:30 PM
Golf, Tennis and Swimming
Cost: $175

Choice of: Golf or Tennis
Ages 10-17
1 PM to 3 PM
Cost: $150

Sports Camp Selection
Name of Sponsoring Club Member *
Your answer
Member Number
Your answer
Payment Method *
Waiver: The undersigned ICYCC member/guardian assumes and understands that he/she assumes full responsibility for any risks associated with attending camp and holds ICYCC and /or their counselors, harmless against any and all bodily injury, and/or property damages resulting from such risks. The undersigned gives permission for photos taken during the course to be used by the Club for publicity/marketing. Sailing instruction waiver and release of liability and assumption of risk agreement: The undersigned Premier Sailing School customer/guardian assumes and understands that sailing is a potentially hazardous sport; that grounding, accidental jibes, man overboards, and equipment failures occur from time to time without warning, and that variations in wind and sea conditions, water traffic, submerged obstructions, and other hazards to navigation exist.In using PSS/ICYCC equipment or participating in sailing instruction or sailing events at Premier Sailing School, the undersigned recognizes and accepts such dangers, and assumes full responsibility for such risks, and holds Premier Sailing School and /or their officers, employees, assistants, or agents harmless against any and all bodily injury, and/or property damages resulting from such risks.The undersigned expressly acknowledges that the New Tides LLC., RRYC, and ICYCC, and related parties have no responsibility whatsoever for sailing school activities. *
Does your child have any allergies we should be aware of? *
Your answer
Please state any medical information or emotional conditions that you think we should be aware of for the safety/comfort of your child:
Your answer
Medical Consent
Please complete the following required information:
I give the following people permission to seek care for this camper (Please include a phone number next to each name): *
Your answer
I agree the above persons can seek medical attention and make decisions on behalf of my camper. *
By clicking "submit" you are electronically signing for this camper and agreeing to all waivers mentioned above. *
A copy of your responses will be emailed to the address you provided.
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