2008 GHYC Sailing Program: ADULT Registration form
Mail in registration starts now. PLEASE NOTE: Walk in registration starts June 1, 2008
Any questions should be directed to Larry Conlon at 781-834-7334
Make Checks Payable to GHYC (registration will not be processed unless $35.00 payment is received for members).
Student Name: ____________________________________________________________
Family Name: _____________________________________________________________
Address: (include mailing address if different):______________________________________
___________________________________________________________________________
City/Town/Zip:______________________________________________________________
Phone Number(s) and times for each to contact:
Home:___________________ Work:_____________________ Cell : _________________________
Insurance Company & Policy:____________________________
Emergency Contact(s)
In case of emergency please contact:
Name:_______________________________________________
Phone:_______________________________________________
Specific Allergies to be aware of: _______________________________________________________
Are there any particular drugs that the participant is allergic to? Please Explain: ______________________________
______________________________________________________________________________________________
Are you a member of GHYC? YES / NO
Please List Student Name(s):
1:__________________________________________________________________________________________
2:__________________________________________________________________________________________
3:__________________________________________________________________________________________
Adult classes will be held in the evenings and will be sailed in both Javelins and the 420’s
Classes for Advanced, Intermediate and Beginner are held at the same times.
Advancement from the Beginner to Advanced class is based upon each students completion of the Beginner program and subsequent requirement check list completion.
Rotation of participants on the Javelin for Adult advanced classes will allow all adult advanced participants a chance to sail the 420’s..
Please indicate which week(s) you are signing up for; enter CODE in above
Make up days will be scheduled by the instructors.
GHYC Sailing Program Minimum Requirements: SWIM 100 yds: TYPE III PFD or better PFD; WHISTLE
All participants must be able to swim 100 yards and have appropriate clothing available, which includes sneakers or boat shoes, warm jacket and or sweatshirt. Each student must have a USCG approved type III personal flotation device, or they will not be allowed to participate in the class. Type III or better PFD’s must be worn at all time while on the GHYC docks and boats and may be required while near the waterfront as well. All students must wear a PFD while in the program. Each Student should have a whistle on a string that can worn or placed in a pocket. The Whistle is required for safety and each student must have one each day.
NEW for 2008: USCG PFD’s : PURCHASE YOUR PFD at SPECIAL PRICE:
USGC Type III and higher PFDs can be obtained at a cost price for participants of the GHYC sailing program.
Contact Green Harbor Marina, 1-781-837-1181: Mr. Dan Vigneau. Identification card from the program (available upon payment), will qualify the participant for the Special discount on the PFDs
Indemnification: By signing below, you agree to all of the following:
I understand that participation in the GHYC Sailing Program is voluntary and may involve some risk, but I regard the benefits to outweigh the risks. I hereby release the GHYC, its instructors, officers, directors members, agents, contractors, employee’s and volunteers of and from any and all actions, claims and damages for personal injuries and disability or death that I, or my child may sustain or incur as a result of participation in or the transportation to or from the GHYC Sailing Program.
I also understand that participation of myself and /or my child in this program will require each of us to wear a USCG approved Type III or better life preserver while on the GHYC docks and boats and waterfront areas.
I give permission for medical treatment to be given if needed. I understand that in an emergency, whenever reasonable an attempt will be made to communicate with me prior to the use of this permission. I further agree to reimburse GHYC for any costs incurred as a result of obtaining medical treatment for my child or myself.
I assume any costs necessary should the participant, whether myself or my child, be sent home due to illness, injury or misbehavior and will reimburse GHYC for any costs incurred.
I agree to reimburse and indemnify GHYC for any damages caused to property owned and/or in the control of Green Harbor Yacht Club or any other party for which Green Harbor Yacht Club may become liable as a result of actions of my child or myself.
I further agree to reimburse and indemnify GHYC for any costs, damages or judgments for property damage or personal injury incurred, including death and that GHYC may be liable as a result of my actions or the actions of my child.
I have read the above requirements and I agree to these requirements. All the above information I have completed in the forms is correct and up to date.
Signature of Parent/Adult:__________________________________________________________________________
Date of Signature: _________________