2024 Sail Camp Registration

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Camp Session Dates* This field is required.Please select the session(s) This form is to register for Race Week in July.
Please Select
Please Select
Race Week: July 8 - 12. Race Week is open to any sailor interested in joining the LBYC Sail Team or sailboat racing
Please choose camp session
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Child's Full Name* This field is required.
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Academic Grade to be completed by June 2, 2024* This field is required.
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Age of child during camp* This field is required.
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T-shirt size* This field is required.Please choose the size for your child's camp shirt.
Please Select
Please Select
Child XSmall
Child Small
Child Medium
Child Large
Child X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
6
Medical Conditions* This field is required.Please alert the sail counselors of any medical condition they need to know about for your child's safety. If none, please type n/a
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Fee Schedule for Camp Sessions* This field is required.If you are an up-to-date member of Long Beach Yacht Club, please select Member Fee. If you are not a current member, please select Non-Member Fee. (Non-member fee includes a junior membership for insurance purposes.)
Please Select
Please Select
Race Week Fee $200.00 (members)
Race Week Fee $250.00 (non-members)
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Has your child ever sailed before?* This field is required.
YESNO
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Payment Information* This field is required.Please send your deposit with this registration form. You can mail a check to P O Box 97, Long Beach Ms or Venmo to Long Beach Yacht Club, Inc.@LBYC-MS Please click "Yes" to agree to submit registration or "No" to wait until later. Your child's spot will only be reserved with the deposit submitted to Long Beach Yacht Club
YESNO
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Payment Information* This field is required.Please send your deposit with this registration form. Choose below to mail a check or pay via Venmo
Pay by Check. Mail to PO Box 97 Long Beach, MS. 39560
Venmo to Long Beach Yacht Club, Inc. @LBYC-MS
Cash. Please bring to club Thursdays - Saturdays. Club opens at 4:00
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Image Field
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Medical ReleaseI, the undersigned, do hereby authorize and consent to any x-ray examination, anesthetic, medical or surgical diagnosis or procedure rendered under the general or specific supervision of any member of the medical staff or of a dentist licensed under the provision of the State of Education Law and or Public Health Law of the State and on the staff of any hospital holding a current operation certificate issued by the State Department of Health. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given the provider the authority and power to render care which the aforementioned physician in the exercise of his/her best judgement my deem advisable. It is understood that effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will be not be withheld if the undersigned cannot be reached.
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Signature RequiredI have read and understand the fee schedule and agree to pay the balance in full by the start of the selected session. I understand that Long Beach Yacht Club does not offer refunds.
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Media ReleaseI give my consent for photographs and/or video footage of my child to be used for the promotion of the Long Beach Yacht Club
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15
Parent/Guardian Phone Number* This field is required.
Please enter a valid phone number.
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Parent/Guardian Name* This field is required.
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Parent/Guardian Email* This field is required.
example@example.com
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Approved for Pick Up* This field is required.Please provide three (3) people who are authorized by you, the parent/guardian, to pick up your child. Contact #1 Name and Phone Number
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Approved for Pick Up* This field is required.Contact #2 Name and Phone Number
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Approved for Pick Up* This field is required.Contact #3 Name and Phone Number
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Signature RequiredI attest the information
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