CLYC 2022 Course Registration

Last Name *

First Name *

Gender *

Male Female

Address *

City *

County *

Postcode *

Phone Number

Area Code Phone Number

Please select a course(more than one may be selected) *

Adult Improvers Course 8-11 Aug (evenings)

Previous Sailing Experience/RYA stages obtained

Emergency Contact Name *

Emergency Number *

Area Code Phone Number

Contact Email (COURSE REGISTRATION confirmation will be sent by email) *

Date of last tetanus shot

Any activity the sailor should be restricted from?

Any physical, mental or other condition that would require special attention or medication while on the course?

List all medications, both prescribed and over the counter, all medications will be turned into the Senior Instructor except inhalers, bring all medication in original containers.

List any allergies (ex: bees,peanuts, dairy)

Any dietary needs that we should know about?

Data Protection Act 1998. The above information including the questions as to your health and ability will be used by us to process your booking for the course and for attending to your safety whilst you are on one of our courses. If you would like to be added to our mailing list in order to receive details of future courses and events please tick below. You may opt out of receiving such details from us at any time by emailing: info@clyc.info. The data will not be shared with any third party for marketing or commercial purposes without first obtaining your explicit consent.

I agree to being added to the CLYC mailing list I agree to name and address details being shared with RYA for the purposes of issuing certificates I agree that photos can be taken and used for club media purposes

Data Privacy. Our Data Privacy Policy can be found at www.clyc.info/privacy-policy/. The above information including the questions as to your health and ability will be used by us to process your booking for the course and for attending to your safety whilst you are on one of our courses. On successful completion of your course your name, certificate number and date of issue will be stored for up to 6 years allowing us to verify or replace your certificate if required. If you would like to be added to our mailing list in order to receive details of future courses and events please tick below. You may opt out of receiving such details from us at any time by emailing: info@clyc.info. The data will not be shared with any third party for marketing or commercial purposes without first obtaining your explicit consent.

I agree to being added to the CLYC mailing list I agree to name and address details being shared with RYA for the purposes of issuing certificates I agree that photos can be taken and used for club media purposes

Please be advised refunds will not be considered for cancellations made 7 days or less from the start of the course.

COVID-19

Please be assured we will be complying with guidance from the relevant authorities. Should we have to cancel we will of course refund the course fee. Should we need to change the format we will discuss this with you also.

Please check your email address is correct as correspondence will be by email only.

Course Fees payable via Paypal.

Please Indicate Payment Method:

Paypal Cheque or Cash

By hitting submit and putting your initials, you agree that you are over the age of 18. In the event of an emergency situation you give consent for medical teatment for the aboved named sailor by authorized personnel.

RISK STATEMENT

It must be recognised that sailing is by its nature an unpredictable sport and therefore inherently involves an element of risk. By taking part in the Event, you agree and acknowledge that:

(i) You are aware of the inherent element of risk involved in the sport and you accept responsibility exposing yourself to such inherent risk whilst taking part in the Event;

(ii) You will comply at all times with the instructions of the Event Co-ordinator/instructors particularly with regard to handling of boats, wearing of buoyancy aids and the wearing of suitable clothing for the conditions;

(iii) You accept responsibility for any injury, damage or loss to the extent caused by your own negligence;

(iv) You will not participate in the Event if your ability to participate is impaired by alcohol, drugs or if you are otherwise unfit to participate;

(v) You will inform the Event Co-ordinator/ instructors if there have been any changes to the information provided on this form at the time of the Event.

(vi) The provision of patrol boat cover is limited to such assistance as can be practically provided in the circumstances;

(vii) You are aware of any specific risks drawn to your attention by the Event Co-ordinator/Instructors.

MISCONDUCT

You understand that the Event Co-ordinator may exclude anyone from a particular session and evict anyone from the premises who refuses to comply with these Booking Terms or who misconducts themselves in any way or who causes damage or annoyance to other persons.

Electronic signature, please initials *

My Products

RYA Adult Course Fee £ 125.00

Quantity

Total £ 0.00

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

CLYC 2022 ADULT SAILING COURSE REGISTRATION

Sailor Information

Emergency Contact Info

Email Confirmation

Health Information

Data Protection

Cancellation Policy

Payment