CYC Youth Sailing Camp Application
You can fill out and print this form on line

Parent/Guardian Name
Child 1 Name Date of Birth
Child 2 Name Date of Birth

Street City
State ZIP
Home Phone Cell Phone
E-Mail Address

Interested in Sailing:     Optimist      Sunfish     Topaz
Parent/Guardian Able to Volunteer Some Time or Skill?    Yes     No
Has Studnt(s) Been to Another Sailing Program?     Yes      No

If Yes:  Where?    When?
Sailing Certificate From:

Consent, Release and Indemnity Agreement

I, , request that my son(s)/daughter(s), , be permitted to participate in the Colington Yacht Club Junior Sailing Program and in consideration of my child being permitted to participate in said activities, I hereby release and discharge the Colington Yacht Club and the Colington Harbour Association, their agents, officers, directors and members from any and all liability of whatsoever kind for any personal injury, sickness, or medical or hospital expense occurring or resulting from or arising out of any activity or substitute activity directly or indirectly connected with Colington Yacht Club’s Junior Sailing Program, and I hereby assume all risk of any liability for injury or damage to the person or property of my son/daughter, while engaged in such activities, however caused, and I further agree to indemnify and save harmless the Colington Yacht Club and the Colington Harbour Association, their agents, officers, directors and members from any and all claims, suits, and liability for injury to the property or to the person of my son/daughter, while engaged in activities at or connected with the Colington Yacht Club Junior Sailing Program.

This program does not provide health and accident insurance since most families already carry such coverage. Because of this, we ask that you, as a parent, recognize the element of risk and agree to assume that responsibility for yourself and your child. 

_____________________________________     ___________
Parent or Guardian’s Signature                         Date
Please Mail this Application Form to: Or Contact Sharon Hildebrant at
Colington Yacht Club
Youth Sailing Program
c/o Sharron Hildebrant
246 OutriggerDrive
Kill Devil Hills, NC 27948
804-366-8480 or
YouthProgram@ColingtonYachtClub.com
 

 

 

After notice of a place in the class, the medical form and
fee of $ 100.00 per sailor for entire program, including Regatta
on 4 August 2018 should be mailed to the above address.