Willamette Sailing Club Youth and High School Sailing

Registration Form

Name: School: Grade

Address: City: State:____ Zip:______ Age:____D.O.B. __/___/___ Home Phone: Sailor’s Cell

Sailor’s Email: Sailing Experience:

Guardian/Mother’s Name: Work phone: Email: Guardian/Father’s Name: Work phone: Email:

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Summer Sailing Program

(A) Beginning Opti and Laser sailors will practice from 4:00 to 6:00 PM
(B) Doublehand (420s) and Advanced Laser sailors will practice from 6:30 to 8:30 PM

Youth Fleet Options $50 per session plus $40 per session if you use a WSC boat:
____ Summer I Tues/Thurs 6/24-7/24 Circle: [(A) 4-6 pm] or [(B) 6:30-8:30 pm]
____ Summer II Tues/Thurs 7/29-8/28 Circle: [(A) 4-6 pm] or [(B) 6:30-8:30 pm]

I need to rent a Club boat (circle one): Laser Opti 420 Not Applicable, I have a dinghy
For more information about the program: http://www.willamettesailingclub.com/youthfleet/

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High School Program (8th-12th Grade)

Fall Season [Labor Day until daylight savings time]

____ $100 Tues & Thurs 4 – 6:30. Doublehand boats (420s) only.

____ $50 Sundays 11:30-12:30. Lasers only.
Spring Season [Mid-February – 1^st of June]
____ $220 Monday, Wednesday, Friday 4-6:30. Doublehand boats (420s) only.
For more information about the program: http://www.willamettesailingclub.com/highschool/

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Membership at the Willamette Sailing Club is required to participate in the Youth Programs. In addition to the necessary liability insurance, membership has numerous benefits. Membership is pro-rated based on the month that you join. Application: http://www.willamettesailingclub.com/membership/wsc_membership_application.pdf
Example: 2008 pro-rated Youth Membership rates and required work hours:
January $190 Work hours 10 February $174 Work hours 9 May $126 Work Hours 6.5
June $111 Work Hours 6 July $95 Work Hours 5 Sept $63 Work Hours 3

___ I am currently a member of the WSC. Membership # is _________

___ I am not a member. (Please attach membership application the enclosed dues)

Membership fees are not refundable. Partial refunds for the High School Sailing Program (fees, minus $50) may be given in the 1st thirty days following registration. Youth Members and/or their parents must fulfill the WSC work hour requirement of 10 hours per year, pro-rated. See membership details on our web site.

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Total amount enclosed $________

The Willamette Sailing Club Youth Sailing Program. Mailing Address: PO Box 69385 -- Portland, OR 97239

Contacts: highschool@willamettesailingclub.com or sailguam@yahoo.com

The Willamette Sailing Club Youth and High School Sailing Program

Emergency Release Form

Name: Age:

Address: _________________________________________________ City:______________________________

Phone:__________________ Emergency Contact E-mail:______________________________(print clearly!!)

Mother’s Name:____________________ Work phone:___________________ Cell phone: _______________

Father’s Name:____________________ Work phone:___________________ Cell phone: _______________

Please list all Known Allergies: ___________________________________________________________________

Do you carry an epi-pen? Yes / No

Do you have Asthma? Yes / No If yes, do you carry an inhaler? Yes/No

Do you have Diabetes? Yes / No
Please List any known condition(s) which may preclude the above named from participating in sailing:

____________________________________________________________________________________________

Please list any known conditions which may require consideration in the event of an emergency:

____________________________________________________________________________________________

In case of emergency, Contact:_______________________________________

Relation:____________________________Phone:_________________________________________

Personal Physician: ______________________________ Phone: _____________________________

Insurance Carrier: _______________________________ Policy #: ____________________________

Group#: _______________________________

Is there anything else we should know?__________________________________________________

Waiver: In consideration of my child participating in the Willamette Sailing Club Youth or High School Sailing program, I agree to accept risks of injury to my child, to hold The Willamette Sailing Club, its Officers, Directors, employees and members harmless from any claims of any nature whatsoever, arising out of the activities of the Youth or High School Sailing Program.

Parent/Guardian Signature: ___________________________________ Date: _____________________

Should the participant be in need of medical treatment, my signature below confirms my permission for this to be done in the event that I cannot be reached promptly.

Parent/Guardian Signature: ___________________________________ Date: _____________________