Quissett Yacht Club

2017 Junior Sailing Registration Form

If you leave this Registration page before completing your payment, your information will NOT be saved.

Questions? Email: camillaking@verizon.net or kristan.first@gmail.com

(* denotes required fields)

Invoice #: 1451551118201743536
Date rec'd: _______
Check #: _______
QYC Member: Y / N

Parent/Guardian Name: *
Address (Summer):* (i.e. 12 Harbor Road, Quissett, MA 02540)
Address (Winter):*
Phone:*
Summer:    Winter:    Cell:
Email:*
Photo Authorization:*
Please indicate if you will allow your child to be photographed and for those photos
to be uploaded to the QYC website or photo sharing website using private access.   
Yes     No       Parent Initials: 

CLASS SELECTION

CHILD'S NAME
Last First Class Requested # Years 
Sailing at QYC
Age on 
July 1
Height/ Weight
(i.e. 5’1” 100lbs)
Session(s)
July/August /Both
Member
(yes or no)
Fee
$0.00
+ Add another student

TOTAL:

$0.00

CLASS TIMES & FEES

Class Meeting Times QYC Members 
1 session/2 sessions
Non-QYC members
1 session/2 sessions
Seaman 8:15 - 10:00 M, T, W*, Th, F $550/$935 $690/$1,260
Adventure Sailing I 10:15 - 12:15 M, T, W, Th, F $525/$910 $675/$1,235
Mate 10:15 - 12:15 M, T, W*, Th, F $550/$935 $690/$1,260
420 I 8:15 - 10:00 M, T, W, Th, F $550/$935 $690/$1,260
Adventure Sailing || 1:30 - 4:30 M, T, W, Th, F $650/$1,085 $750/$1,325
Opti Race Team 1:30 - 4:30 M, T, W, Th, F $675/$1,125 $790/$1,425
420 Jr. Race Team 10:15 - 12:15 M, T, W, Th, F $600/$1,000 $700/$1,275
420 Race Team 1:30 - 4:30 M, T, W, Th, F $675/$1,125 $790/$1,425
*Wednesdays are reserved for voluntary learn-to-race opportunities. Seaman and Mate Wednesday races will not be held when too many QYC boats are being used by the Opti Race Team at away races. Parents will be notified in advance.
** Sailors may enroll in Adventure Sailing for a week at a time.

New Sailors: please describe past sailing experience (boats, rigging type, classes, number of years):

 



Quissett Yacht Club

2017 Medical Information and Consent Form

If you leave this Registration page before completing your payment, your information will NOT be saved.

CONTACT INFORMATION (* denotes required fields)
Name of Participant:*
DOB:* (i.e. 05/20/01)    Age:*     Gender:* Male   Female
Name of Parent or Guardian:*
Address (Summer):* (i.e. 12 Harbor Road, Quissett, MA 02540)
Address (Winter):*
Phone:* Summer
Cell
Winter
Phone/Email:*

(Best way to reach you during class hours) 
EMERGENCY CONTACT   If the person above is not available in the event of an emergency, notify:
Name:* Relationship:* Phone:*
Name:* Relationship:* Phone:*
 
INSURANCE INFORMATION
Doctor's Name:* Phone:*
Name of Insurance carrier:*  Policy#:*
In the case of an emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the physician selected to secure the proper medical treatment, which may include hospitalization, anesthesia, surgery or injection of medication for my son/daughter.
Signature of Parent/Guardian:  By placing a check in this box I hereby sign this form.*    Date:*
 MEDICAL INFORMATION
Medical Conditions: My child has a medical condition that should be known to a person rendering medical assistance.  

Concussions: Has your child ever had a serious head injury or concussion?  

NOTE: If you answered yes to either of the questions above, you are REQUIRED to send an email to the QYC Jr. Sailing Program registrar, Camilla King at camillaking@verizon.net. Please list all medical conditions and if your child has had a concussion, indicate the severity of the concussion and the date of occurrence.
 
Waiver: The undersigned parent/guardian recognizes that an element of risk is involved in all sports, including sailing. In consideration of my child participating in the Quissett Yacht Club’s sailing, racing or other club activities, I agree to release, hold harmless and indemnify the Quissett Yacht Club, its officers, directors, employees and volunteers from any and all claims, losses, damages, fees and liability for injury to our child/ward or damage to any property arising out of, resulting from, related to, or in any way connected with the operation of the Quissett Yacht Club Junior Sailing Program or any activities or the use of any of its facilities or equipment of the Quissett Yacht Club.
Signature of Parent/Guardian: By placing a check in this box I hereby sign this form.*         Date:*  


Quissett Yacht Club

2017 Parent Volunteer Sign-up Form

If you leave this Registration page before completing your payment, your information will NOT be saved.

Name:
Phone/Email:

(Best way to reach you during class hours) 
Student(s) name(s) 

CLASS PARENTS

Monday, June 26th to
Friday, July 21st
Monday, July 24th to
Friday, August 18th
Seaman Class Parent:
(Interface with instructor and parents,
arrange class picnic, etc.)
Mate Class Parent:
(Interface with instructor and parents,
arrange class picnic, etc.)
Opti Race Team Parent:    

Trailer boats to/from a regatta
(do you have a hitch and a 4-way
flat light connector?)

Help load boats onto trailers
before regattas (Tuesdays 4:00pm)

QYC Hosted Unkie Regatta (July)

   

Parent coordinator

 

Registration

 

Banner

 

Morning refreshments

 

Lunch

 
420 Race Teams    
Trailer boats to/from regattas (do you have a hitch
and a 4-way flat light connector?)
Coordinate carpools for one regatta.
Escort boats by water to/from regattas (do you
have a boat that can tow, escort, transport kids?)
AWARD BURGEES     
Sew Award Burgees
(need access to sewing machine)