Junior Learn to Sail course 2018-19

Youth Learn to Sail Course Registration Form

Course dates and more details are available on our website at https://paremataboatingclub.org.nz/learn-to-sail/
Name of Sailor*

First NameLast Name
Birth Date*

DayMonthYear
Address*
Name of Parent/Guardian 1*

First NameLast Name
Name of Parent/Guardian 2

First NameLast Name
Home Phone
Work Phone
Mobile Phone 1*
Mobile Phone 2
E-mail 1*
E-mail 2
Medical conditions & confidence issues the instructors should know about:
Fees: $355 - direct credited to Westpac 03 0547 0016903 00 (incl LTS and Surname as reference)
Date fees were credited

DayMonthYear
Are you interested in assisting the instructors during the session in the patrol boats?

YesNo
How did you hear about our course?
Declaration by Parent / Guardian:

I have read the course outline available in our website https://paremataboatingclub.org.nz/learn-to-sail/

My child can swim 50 metres and remain in the water for 15 minutes unaided wearing a buoyancy aid and light clothing.

During the course my child will follow all safety instructions given. My child will wear a buoyancy aid at all times when on the water.

I understand that the Paremata Boating Club Inc. does not accept any liability for personal injury or damage or loss of property as a result of my child taking part in this course.

By signing below I agree to the above
Please let our secretary know at PBClubSecretary@gmail.com if you don't want your child's photos taken during club's activities to be used for club's purposes (e.g. on club's website, Facebook page, club's promotional activities etc.). Thanks.
Parent Signature (please type name)
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Youth Learn to Sail Course Registration Form