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Inverness Yacht Club

Adult Sailing Lessons Application

FEE AND SCHEDULE: Please refer to the Fee and Schedule Page

TO ENROLL:

  1. Please complete this online Application form.
    • Every Participant of age 18 years or older must fill out and sign their own application.
    • If you prefer to receive a PDF copy of this application form via email, please contact the Adult Sailing chair to arrange for that.
  2. Send check made out to Inverness Yacht Club to: IYC Adult Sailing c/o Ned Congdon, 115 Clover Hill Court, Danville CA 94526.

Refund Policy:

A full refund is granted if the student withdraws 14 or more days before the session starts. There may be a 50% refund if withdrawal precedes the beginning of class. No refunds are given once the class has started.

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Parent or Guardian's Email Address

Email*

Confirm Email*
I will participate in the IYC Adult Sailing Lesson Program. I agree to indemnify and hold harmless the instructors and leaders of these programs, the Inverness Yacht Club and its Officers, Directors and Employees, and absolve them of any responsibility should an injury occur to me, notwithstanding any fault or neglect of any of them. I further agree to be responsible for and promptly reimburse the IYC for any damage that may be done to IYC boats or facilities used by me. I further give permission for me to receive medical treatment from any licensed physician in the event of an emergency.
Selection required.*
No
Yes
I understand that acceptance of me as a student in the Adult Sailing Lesson Program of the Inverness Yacht Club is subject to the following. Note: All check boxes MUST be checked for your application to be considered.
The demonstrated ability of the student to pass a swimming qualification *
I understand
The requirement that the student must provide and wear a Coast Guard approved Type III life jacket. *
I understand
The student following the direction of the Program Instructors and Staff. *
I understand
The understanding that drugs or alcohol consumed before or during an Adult Sailing lesson will result in dismissal. *
I understand
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Address

Current Address *

Summer Address (if different)

Summer Phone
IYC Member?*
No
Yes
Experience (check one) *
First-time or inexperienced sailor
Beginner (can steer, tack, jibe, and dock)
Intermediate (can rig and unrig boat, leave/return from dock/mooring, set a course)
Advanced (can handle all trim functions and high winds)

Please summarize your sailing experience and previous instruction (where, when, what boats):
Swimming ability (check one) *
Weak Swimmer
Adequate Swimmer
Strong Swimmer

I have the following allergies, medical or special learning conditions (if none, say "None") *

Minors: If Participants of age 12-17 are to be included,please add the preceding information for them in the box below.

Emergency Contact #1: Name *

Emergency Contact #1: Phone *

Emergency Contact #1: email address

Emergency Contact #2: Name

Emergency Contact #2: Phone

How did you hear about IYC's Adult Sailing Lesson Program?
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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