Picture Optis Racing
Daytona Beach, Florida
  
 
 
 
 

 
 
Welcome To SailCamp Registration

Please complete this form and then click the Register button to go to the payment screen.

SailCamp REGISTRATION

FEE PAID: $250.00
Date
Applicant (parent to complete):

Name Sex:

Date of Birth T-Shirt Size

School/Club Affiliation Grade

Address
No.       Street       City     State      Zip

Phone Home       Cell
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Parent/Guardian (parent/guardian to complete if applicant is a minor):

Father's Name

Phone Home      Cell

Mother’s Name

Phone Home      Cell

Emergency Contact 
Name Phone  Relationship

Email [confirmation]

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Please select a SailCamp date below:

SailCamp # 1 - June 14 - June 18
SailCamp # 2 - June 21 - June 25
SailCamp # 3 - June 28 - July 2
SailCamp # 4 - July 5 - July 9
SailCamp # 5 - July 19 - July 23
SailCamp # 6 - July 26 - July 30 (Catamaran - $300 - Requires
             Previous SailCamp or Director's Approval)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SailCamp Information (parent to complete):

SailCamp is a five-day, daylong camp experience designed to teach basic sailing skills to children age eight to 18. SailCampers are expected to be on time, fully equipped, and ready to participate every day of SailCamp. I understand these requirements and have communicated this to my child and signify same here.    Initials     

Can your SailCamper swim approximately 50 yards.using
any stroke, in sailing clothing and shoes/booties?    Yes     No   

Not Sure

Your SailCamper's previous sailing experience

I assume full responsibility for any loss or damage, excepting loss or damage covered by insurance, that may come to any person, boat, sailboard, equipment, pier, float, or other property used in conjunction with SailCamp as the result of improper use, negligence, violation of the rules, and other acts of sailors, or other representatives of the school, instructional program or host location in connection herewith. I accept that the sport of sailing and the conduct of this course entail and are subject to certain inherent risks and assume all risks on land and on the water of participation in this program. I further agree to hold the school, instructional program or host location, US SAILING, and their representatives harmless for personal injuries and/or property damage.

Signature [please type in your full signature name]       Date
Applicant, or Parent/Guardian (if a minor)

 

 
GALLERY
 
   

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Halifax Youth Sailing © 2010