AL2S Form

Adult Learn to Sail

Napier Sailing Club
Adult Learn to Sail is open to Members and Non Member a like, to Qualify for Members pricing you must hold an active sailing membership.

Fees
·         Club Members: $160 per person for the 3 sessions.

·         Non-members: $240 per person for the 3 sessions

Each session will be 2.5 hrs with follow up sessions if Requested
Current Club Membership*

Non MemberSenior (19+)SpouseIntermediate (14 - 19)Associate (Parent / Volunteer)Social
Preferred Sessions*

Tuesday Evenings 4th, 11th, 18th, February 5.30pm
Name*

First NameLast Name
Email*
example@example.com
Mobile.*
Address

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical Conditions*

YesNo
Medical Condition: please specify.
Emergency Contact

Details
Name*

First NameLast Name
Relationship*
Contact Number*
DISCLAIMER OF LIABILITY
CONDITIONS OF PARTICIPATION (Please complete, read carefully & sign)
I agree to be bound by the Rules of Sailing and all other rules that govern this course. I understand that sailing has inherint risk and dangers that are beyond the control of the organising authority. I understand that neither the organising authority and its officers, members and servants nor other persons assisting with the conduct of the course accept any responsibility in repesct of any injury or loss to person or property that may be sustained by reason of participation in the course or howsoever aring in connetion with the course.

I agree to the use of my photograph(s)and other relevant information in any event, publicity and in the ongoing promotion of New Zealand yachting, I agree to the Organising Authority and Yachting New Zealand holding the above information for the general administration and well-being of the sport, and for them to retain, use and disclose the information to affiliated organisations and any other persons or organisations the Yachting New Zealand believes will further the interests and objectives of yachting New Zealand. I acknowledge my right to access to and correction of this information. This consent is given in accordance with Privacy Act 1993.
Signed*

Clear
Date*

MonthDayYear
Date
Return this form by email to: manager@napiersailingclub.org.nz

Please make an online payment to the Napier Sailing Club account 03 0698 0040708 00 quoting AL2S and surname as References, or like wise in Office during business hours.
Should be Empty:

Adult Learn to Sail

Emergency Contact

DISCLAIMER OF LIABILITY