2010 Registration and Liability Release
Basic Sailing Classes: Please Pick First and Second Choices
Session 1: June 7 – June 18
Morning 9 - 12 Noon______
Afternoon 1 - 4 PM _____
Session 2: June 21– July 2
Morning 9 - 12 Noon FILLED
Afternoon 1 - 4 PM FILLED
Session 3: July 5- July 16
Morning 9 - 12 Noon FILLED
Advanced Course In Afternoon
Session 4: July 19- July 30
Morning 9 - 12 Noon _____
Afternoon 1 - 4 PM _____
Session 5: Aug 2 – August
13
Morning 9 - 12 Noon _____
Advanced Course In Afternoon
Name ________________________________________ Sex _____ Date of Birth____/____/____
Address_____________________________________________________________ Zip __________
Phone __________________E-Mail _______________________________________________
I hereby grant permission for ________________________ to participate in sailing instruction given by the Venice Youth Boating Association, Inc., including on the water training in boats owned and operated by the Association. I _____________________ further release the Venice Yacht Club and their officers, and the Venice Youth Boating Association, Inc. and their officers and instructors from any liability in the event of injury or accident to the above named individual, while on the grounds of the Venice Yacht Club, or on the water, during the Venice Youth Boating Association, Inc. supervised instructional sailing activities. I fully understand the risks involved in any sailing program, and with this knowledge, will allow my child ____________________________ to participate in the sailing program. Note: Any child who behaves in such a way that endangers the safety of himself or others, is continually disruptive in class, or is repeatedly tardy from class will be asked to leave the session for the remainder of the session, or possibly banned from further participation in any classes. No refunds of any kind will be made.
Signed _________________________________________ (circle - Parent or Guardian)
Date _____________