Fields marked with an * are required
Open to WBYC Members only, ages 5-10.
If you have any questions regarding the Sailfish program, please contact the WBYC Sailfish Coordinator Lisa Senehi at (315) 655-3737 or firstname.lastname@example.org.
Child #1 Information
Sailfish sessions meet Monday and Wednesday, 1-4 PM.
⇒ Note: No Sailfish the week of July 4th ⇐
- Full Season: First child is $165; each additional child is $150.
- Weekly Sessions: First is child $30; each additional child is $25.
Parent/Guardian and Emergency Contact Information
Total Cost and Payment Method
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 Sailfish Program. In consideration of the Willow Bank Yacht Club providing 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 childrens' participation in the Sailfish 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 sports of swimming and sailing, in water sports in general, and in any activity involving children. I understand that I am responsible for providing my child with a U.S. Coast Guard approved Type III personal flotation device for use at all times while participating in sailing activities. 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 cannot be reached.
By checking the box below, I indicate that I have read and attest that the above is true and correct.