Fields marked with an * are required
Please contact the WBYC Jr. Sailing Coordinator Susan Light at (315) 655-5706 or email@example.com for any questions regarding the Junior Sailing program.
Child #1 Information
- Sessions 1 – 3: First session or child is $140; each additional session or child is $130
- Session 4: First session or child is $70; each additional child is $65.
- Cost can be billed to your WBYC account or you can send us a check.
- Sessions 1 – 3: Add $40 boat fee for each session
- Session 4: Add $20 boat fee for each session
- Cost must be paid by check prior to the beginning of lessons.
Parent/Guardian and Emergency Contact Information
Total Cost and Payment Method
Send one check for the total cost of all children registered to: Willow Bank Yacht Club PO Box 321 Cazenovia NY 13035
I, the parent or guardian named on this form, hereby authorize the child or children named on this form, hereinafter referred to as "my children," to participate in the Willow Bank Yacht Club Swimming Lessons Program. In consideration of the Willow Bank Yacht Club providing swimming instructions to my children, I hereby release, acquit, and discharge the Willow Bank Yacht Club its successors and assigns, its employees, agents, members, volunteers, officers and directors from all claims, demands, actions, causes of action, damages, injuries and cost of any nature or kind whether property, personal injury or bodily injury or any other type of injury or damage that may arise from my children's participation in the swimming program as well as use of the facilities of the Club, and its equipment. This release is on my behalf as the parent or legal guardian and on behalf of my children and any person claiming through my children.
I understand the risks inherent in the sport of swimming and in water sports in general, and in any activity involving children. I attest that my participating children are free and unencumbered from any physical or mental impairment and are free of any contagious or infectious disease that might interfere with their health or safety during this program.
I give authorization to the Willow Bank Yacht Club to provide or seek treatment for my children in the event of any accident or injury if I can not be reached.
By checking the box below, I indicate that I have read and attest that the above is true and correct.