Sailing Camp 2018 Registration Form

Child's Name:
Child's Birth Date:
Allergy/Medical Conditions/Concerns:
Parent/Grandparent Name:
Address:
Email Address for Confirmation:
HOME
OFFICE
CELL
Please list all the name(s) of all persons authorized to pick up your child: *
Beginner 8 Years & older
Experienced 8 Years & Older Optimist Pram
Experienced 10 Years & Older JY-15
PLEASE TICK YOUR CHOICES
Signature
Membership #/Sponsor Name:
Date: