2017-18 BYC Race Team Winter Practice Registration Form Bellingham Yacht Club 2017-18 Winter Practice for the BYC Race Team 2017 (Medical Waiver and Registration Form). Step 1 of 2 50% Applicant InformationName*Enter name of the youth applicant. First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Cell/Emergency Phone*Primary Contact Phone Number (Daytime)Birth Date*Min. Age - 8 yrs. MM DD YYYY Weight(Pounds)Email*Primary Contact Email Enter Email Confirm Email SchoolName of Applicant's SchoolSailing Experience*Choose appropriate experience level.BeginnerIntermediateAdvancedSwimming Experience*Choose appropriate experience level.BeginnerIntermediateAdvancedAllergies and/or Relevant Medical Conditions of Concern:(Diabetes, Epilepsy, Heart Disease and history of Hypothermia are generally considered relevant to cold water sports.)Contact InformationParent/Guardian Name* Daytime Phone*Evening Phone*Parent/Guardian Name Daytime PhoneEvening PhoneEmergency Contact Name Daytime PhoneEvening PhoneEmergency Contact Name Daytime PhoneEvening PhoneApplicant's Physician Daytime PhoneApplicant Acceptance/AcknowledgementI, the above-named Applicant, do hereby agree to adhere to the bylaws, rules and/or policies of the Bellingham Yacht Club. I understand that my failure to do so will jeopardize my ability to continue to participate in Club activities, including training and racing. I agree to treat Club property, including boats, with care and to follow all safety and other practices required by the Club, its officers, trustees, volunteers or employees. By joining the race team you are also eligible to become a Junior Instructor. Being a JI helps you attain the knowledge and practical skills useful for becoming a certified instructor under the direction of our current instructor team. Contact the Youth Sailing Director for more information.Acceptance* I accept the above statement. Acceptance Date* Parent/Guardian Approval/WaiverThe Parent/Guardian of the Student is required to read the "Release of Liability, Waiver of Right to Sue and Agreement to Indemnify and Hold Harmless" document and print and sign a copy of the document and return it to the BYC. The signed copy of the waiver must be received by the BYC before the student can participate in any class. The waiver can be brought to the first day of class. If the Parent/Guardian is registering more than one student, a copy of the waiver must be submitted for each student. I also agree to allow use of any photos taken of the participant during the class to be used for Bellingham Yacht Club promotional purposes, including, but not limited to use on the BYC website and promotional flyers.Parent/Guardian* Acceptance* I accept the above statement. Date* How did you hear about us?*Family or FriendBellingham Leisure GuidePosterOtherOther Winter Practice Registration Options 2017/18 BYC Race Team Winter Practice There will be a total of eight (8) weekly practice sessions beginning Sunday, December 3rd, 2017 and will continue until mid-February except during the Christmas holiday. Practice will be conducted in Lasers and possibly 29ers (weather permitting). For more information about the practice sessions including meeting times, firm dates and meeting place, please contact Gavin Brackett via email at firstname.lastname@example.org or phone (360) 317-8249. 2017-18 Team Winter Practice Registration OptionsWinter Practice - Non-BYC MemberWinter Practice - BYC MemberTotal $0.00 PaymentPayment Options*Select Payment Option. Do not send cash by mail.Credit Card via PayPal (PayPal membership not required)Charge to BYC Account (Members only)Mail CheckPayment Information Payments are accepted by check, credit card via PayPal (PayPal membership is not required) or for BYC members, charged to your BYC account.. If paying by mail, make a copy of the PDF document attached to your email confirmation of this application and send it along with your payment to: BYC Youth Race Team Winter Practice Registration Bellingham Yacht Club 2625 S. Harbor Loop Drive Bellingham, WA 98225 For questions regarding this form or about the Youth Race Team contact Gavin Brackett at (360) 317-8249, email: email@example.com This iframe contains the logic required to handle Ajax powered Gravity Forms.