LTS – Manly 16ft Skiff Sailing Club

Are you a Member of Manly 16ft Skiff Sailing Club?

Yes
No

Number of Members Children Registering*

Number of Children Registering*

Child 1 Name*

Child 1 Date of Birth*

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Child 2 Name

Child 2 Date of Birth

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Child 3 Name

Child 3 Date of Birth

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MM

YYYY

Child 4 Name

Child 4 Date of Birth

DD

MM

YYYY

Can Your Child/Children Swim 25m Unassisted?

Yes
No

Unfortunately your application can not be accepted at this stage. It is a mandatory requirement that all students wishing to partake in the Manly 16ft Skiff Sailing Club Learn to Sail programme must be able to swim 25m unassisted.

Your Contact Details

Mothers Name

First

Last

Mothers Phone

Mothers Email

Fathers Name

First

Last

Fathers Phone

Fathers Email

Address

Street Address

Address Line 2

City

ZIP / Postal Code

I hereby give my consent for my child/children to participate in the Manly 16ft Skiff Sailing Club Learn to Sail Programme. I am aware of the contents of the Manly 16ft Skiff Sailing Club’s Risk Warning (see below). I hereby release the Manly 16ft Skiff Sailing Club, and any representatives thereof, from any claim or demand that I may have or deem myself to have on my behalf arising out of the Training Program and indemnify the Manly 16ft Skiff Sailing Club and any representatives thereof against any claim that may be made. I also authorise Club representatives to seek appropriate medical assistance as required.

Manly 16ft Skiff Sailing Club Risk Warning

Whereas the Manly 16ft Skiff Sailing Club (the club) undertakes that all Sail School staff are very experienced and competent sailors and all care will be taken to ensure the safety of all participants it should be understood that participation in the sport of sailing carries a risk of personal injury and I understand that risk and that the club is not responsible for any harm or injury suffered by any person in any sailing event conducted or hosted by the club of whatever nature. All parents or guardians and participants acknowledge that competing in sailing events may be dangerous and may result in harm or personal injury and participate in such events aware of such dangers and voluntarily accepting any risk of harm.

Signature – Your Name and Date

Payment Details

Total

$ 0.00

Credit Card

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date

Security Code

Cardholder Name