RYC 29er SAILING SCHOOL 2011/2012
Dear Parents and 29er Sailors,

Welcome to the 2011/2012 29er Sailing School at the Richmond Yacht Club. We look forward to meeting each of you on October 8th.  

For those of you planning to participate in more than one class, you may use this form to sign up for the 29er program and either the Laser or the High School program (this year we are not offering the option to participate in both the Laser and the High School programs).

The 29er program runs from October 8th until May 26th.  

Please add a $50 late fee to applications received at the RYC after September 30th.

Please complete a separate application form for each program participant. Please attach a separate check for each program participant.

HELPFUL HINTS

Before starting the on-line registration process, please have the following available:
Doctors Name, phone number and area code
Medical insurance company name and policy number
Date of last tetanus shot (if any)
Emergency contact information (two emergency contacts required)
Check book (you will be asked to input the check numbers/amounts)
A printer (you have to print and sign this form prior to submitting it)

PRINTING AND SUBMITTING THIS FORM

When you get to the end of this form, please PRINT the form PRIOR to hitting the submit button.
Once the form has been printed, parents/guardians please sign the form (if the participant is under the age of 18) and also have the participant sign the form. Please attach the check to the form and mail the form and the check to:

29er Sailing School
Richmond Yacht Club
P.O. BOX 70295
Point Richmond, CA 94807

If you have any questions about the program or completing the forms, please contact Dan Brandt dan.higherfastervmg@gmail.com.


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First Name *
Last Name *
Street Address Line 1 *
Street Address Line 2
City,  State,  Zip *
Parent(s)/Guardian(s) First and Last Names *
Parent/Guardian Street Address,  City,  State,  Zip Code *
This information may be used to contact you in case of emergency.
Parent/Guardian Primary Phone Number and Area Code *
This information may be used to contact you in case of emergency.
Parent/Guardian Secondary Phone Number and Area Code
This information may be used to contact you in case of emergency.
Parent/Guardian Primary Email Address *
Email will be the primary source of communication during this sailing program.  If for some reason class has to be cancelled, you will be notified via email.
Parent/Guardian Secondary Email address
Email will be the primary source of communication during this sailing program.  If for some reason class has to be cancelled, you will be notified via email.
29er Participant email address
Sailor Birth Date (MM/DD/YR) *
Insert birth date in Month, Day, Year format (e.g. 07/26/96)
Age *
Gender *
Describe the type of RYC membership you currently hold *
Program Fees (fees do not cover cost of regattas) *
Please read the fee menu carefully.  Note. Participating in the HS program and the Laser program is not an option this year.
Required
Boat Storage Fees *
If the club bills you directly for boat storage, please check "No Boat Storage" and pay the club invoice
Required
Late Fee (applies after September 29th) *
A late fee of $50 will be charaged to all participants who complete this form after September 30th.  If applicable, please add the late fee to your check.
Required
Check number for the check attached to this application *
$ amount for the check attached to this application *
Add Program Fees, Boat Storage Fees and Late Fees if applicable
T-Shirt Size *
High School you are attending *
If you are not attending High School, please type N/A
Do you have a medical condition of which we should be aware?  If yes, please describe. *
Are you on any medication?  If yes, please list medications. *
Date of last Tetanus shot (month and year) *
If you have not had a tetanus shot, please type none.
Name of Physician *
Physician's phone number and area code *
Name of Insurance Carrier *
Insurance Policy Number *
First Emergency Contact:  (name, phone number with area code, relationship) *
In case of emergency we will first try to contact the parent/guardian.  Failing that, we will call the emergency contact.
ASSUMPTION OF ALL RISKS, WAIVERS, AND RELEASE
I acknowledge that sailing and its related activities carry various risks of property damage, injury and even death. In return for permitting me to participate in the Richmond Yacht Club Junior Sailing Program (hereinafter referred to as "the event"), I, on behalf of myself and anyone else who might or could make a claim if I am injured or killed or my property is damaged, DO HEREWITH VOLUNTARILY ASSUME ANY AND ALL RISKS OF ALL SUCH ACTIVITIES. BY THIS DOCUMENT, I EXPRESSLY INTEND TO AND DO HEREWITH WAIVE IN ADVANCE, AND DO HEREWITH RELIEVE AND RELEASE ALL THOSE PERSONS AND ENTITIES INVOLVED IN ANY WAY IN PUTTING ON THE EVENT (including but not limited to the event sponsors, the event committee, the Richmond Yacht Club, their officers, directors, members, volunteers, employees, servants, agents, contractors, subcontractors, heirs, next of kin, successors, or assigns, all hereinafter collectively referred to as “Hosts”) FROM, ANY AND ALL LIABILITY FOR PERSONAL INJURY, DEATH, AND/OR DAMAGE TO PROPERTY, ARISING OUT OF OR IN ANY WAY CONNECTED TO MY PARTICIPATION IN THE EVENT AND/OR ANY RELATED ACTIVITIES, prior to, during, or after the event, whether on or off the water, EVEN IF SUCH INJURY, DEATH, AND/OR DAMAGE IS CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR OTHER FAULT OF SUCH PERSONS OR ENTITIES, BY THE DANGEROUS OR DEFECTIVE CONDITION OF ANY PROPERTY, PREMISES (including but not limited to the Club, docks, ramps, floats, etc.) OR EQUIPMENT OWNED OR MAINTAINED OR CONTROLLED BY THEM, AND/OR BECAUSE OF THEIR LIABILITY WITHOUT FAULT.
 
I agree that the jurisdiction and venue for any dispute will be Contra Costa County, California, and that California law will govern any arbitration or litigation.  If any provision of this Waiver and Release is determined to be illegal, unenforceable, or otherwise invalid for any reason, such provision will be deemed to be severed and deleted. Neither such provision nor its severance and deletion shall in any way affect the validity of the remaining provisions.  I have read this agreement and fully understand its contents.  I am aware that this is a release of liability and a waiver of all claims, and I sign of my own free will.

MEDICAL EMERGENCY: In case of an emergency due to illness or accident, when the RYC cannot contact Parent/Guardian or Emergency Contact(s), the RYC authorities have our permission to use their best judgment in the interest of our child’s health. It is understood that the effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that the treatment will not be withheld if the undersigned cannot be reached. I/We understand that the RYC does not provide accident medical insurance for the program participants. I/We further understand that all costs related to medical treatment shall be my/our responsibility and not the RYC responsibility. I/We further understand that the RYC may release any medical information to the medical providers.
Participant:  I certify that *
PARTICIPANT NAME AND SIGNATURE *
PLEASE PRINT THE PARTICIPANTS NAME AND TODAYS DATE IN THE BOX BELOW.  When the form is printed, the participant must sign the form next to his/her name in the box below.  FOR PARTICIPANTS WHO ARE OVER 18, please read the contents of the section titled ASSUMPTION OF ALL RISKS, WAIVERS, AND RELEASE.  By signing this form, you are agreeing to all of the provisions listed in the ASSUMPTION OF ALL RISKS, WAIVERS, AND RELEASE and further you are certifying that the information provided on this form is true and correct to the best of your knowledge.  The undersigned further authorizes and consents to emergency medical treatment should the same become reasonably necessary during the child’s participation in the event and/or any related activities. The undersigned understands that he/she is responsible for any and all medical bills.
PARENT/GUARDIAN NAME AND SIGNATURE for Assumption of all risks, waivers and release. *
PARENT/GUARDIAN PLEASE PRINT YOUR NAME AND TODAYS DATE IN THE BOX BELOW.   The undersigned does hereby represent that he/she is, in fact, acting in such capacity and on behalf of himself/herself and the above-named child, agrees to and accepts all of the terms and provisions of foregoing WAIVER AND RELEASE OF LIABILITY. The undersigned further authorizes and consents to emergency medical treatment for the child should the same become reasonably necessary during the child’s participation in the event and/or any related activities.
PRINT THIS FORM NOW - DO NOT SUBMIT THE FORM UNTIL IT HAS BEEN PRINTED
A signed hard copy of this complete form must accompany your check.  Do not submit this form unless it has been printed.  Once the form is submitted, you cannot retrieve it in this format again.  You will have to fill out the form again unless you have printed and signed this form.
Have you printed this form?  If yes, click on the submit button.  If not, print the form NOW and then click the Submit button *
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