Scholarship Registration

Date:

Sailor Information:

* Name:

* Age of Sailor (must be 8 years old to be participate)

Must turn 8 by August 31.

Experience:

Please list your child's medical conditions or allergies

Class Information:

* 2024 Session Dates

Session 1A: 6/24 - 7/5

Session 1B: 7/8 - 7/19

Session 2A: 7/22 - 8/2

Session 2B: 8/5 - 8/15

* Select a level:

Parent or Guardian Information:

* Name:

* Email:

* Email 2:

* Address:

* Phone number:

How did you learn of this Scholarship Provider?

* Which organization provided the Scholarship to attend the Sailing Program?

* How did you learn of this program?

Emergency Contact Information:

* First Contact Name:

* Relationship to Sailor:

Phone number:

* Second Contact Name:

* Relationship to Sailor:

* Phone number:

Notes:

You must review and sign the attached forms and submit them on the first day of class. WITHOUT THESE, THE STUDENT CANNOT SAIL.

Parent/Guardian Release and Convenant & Consent for Medical Treatment

Please pay on PayPal after submitting your registration or bring payment on the first day of class.

* Denotes Required Field

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