Premier Sailing School Young Sailor Registration form 2019
Email address *
Students First Name *
Your answer
Students Last Name *
Your answer
Home address of student (full mailing address) *
Your answer
Name of parent *
Your answer
Parents phone numbers *
Your answer
Name of Guardian during camp if different from above
Your answer
Contact Phone numbers to be used during sailing week - this is most important! *
Your answer
Students age (as of 1st June this year) *
Your answer
Approx weight of student
Your answer
Certificate Stage reached last year (if a returning student and if they can remember) eg. Stage 1, Stage 2
Your answer
Can he/she swim? *
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
Notes - this is a space for you to add comments or question.
Your answer
How did you hear about us? *
Your answer
Sailing weeks requested at Tides Inn location
Sailing requested at Rappahannock River Yacht Club location
Waiver
Waiver 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 Premier Sailing School’s 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, ICYCC, and and related parties have no responsibility whatsoever for sailing school activities. The undersigned gives permission for photos taken during the course to be used by the school for publicity/marketing. *
Required
Medical Consent
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.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service