2024 Summer Sailing Program
Fill out this form completely to register for the Pacific Corinthian Youth Foundation's Summer Sailing Camp! Our facility is in Channel Islands Harbor on the grounds of Pacific Corinthian Yacht Club (PCYC), 2600 S Harbor Blvd, Oxnard, CA 93035. Select "Save" as you go along and you will receive a link to continue to complete this form later. Registration is not complete until the form has been submitted and fees paid.
Student 1 Information
Student 1 Name
*
First Name
Last Name
Date of Birth (eligible between 01/01/2006 and 12/31/2016)
*
/
Month
/
Day
Year
Date
Gender
*
Male
Female
N/A
Student's Home Town
*
City & State (or Country, if outside the US)
Sailing Skill Level
*
Please Select
Beginner
Advanced Beginner
Intermediate
Advanced
Is Student 1 registering for a single session or multiple sessions?
*
Single
Multiple
1st Choice Session
Please Select
Session 1 - June 17-28, 2024
Session 2: July 1-12, 2024
Session 3: July 15-26, 2024
Session 4: July 29-August 9, 2024
2nd Choice Session
Please Select
Session 1 - June 17-28, 2024
Session 2: July 1-12, 2024
Session 3: July 15-26, 2024
Session 4: July 29-August 9, 2024
Select each session Student 1 wishes to attend:
Session 1: June 17-28
Session 2: July 1-12 (no class July 4; make-up day upon request)
Session 3: July 15-26
Session 4: July 29-August 9
Additional Comments regarding your session choices:
Does the Student have any medical conditions, such as allergies, hyperactivity, eyeglasses/contact lenses, sun sensitivity, injuries, or physical or learning disabilities?
*
No
Yes
Please elaborate on the Student's medical condition(s), medications (if any), and concerns to share with the Student's PCYF Instructor:
In the event of a Medical Emergency, PCYF will first attempt to contact the individuals listed as Emergency Contacts. As an additional emergency contact, please provide the Student's Physician/Medical Group Name, City, and Phone Number:
*
Visual Media Consent (Student 1)
I give Pacific Corinthian Youth Foundation (PCYF) permission to make photographs, videotapes, films, or other likenesses of my child/legal ward and me. I hereby grant PCYF the unrestricted right to copyright any of the above-mentioned materials containing images of us as well as the unrestricted right to use and reuse them, with their caption information, in whole or in part, in any manner, for any purpose, and in any medium now known or hereinafter invented, in perpetuity, and in all languages throughout the world. These rights include, but are not limited to, the right to publish, copy, distribute, alter, license, and publicly display these materials for editorial, trade, marketing, and/or advertising purposes. I also grant PCYF and its licensees the unrestricted right to use and disclose our names in connection with the use of the above materials. I understand and agree that we will not be paid for any use described above. I also waive, release, and discharge PCYF, its officers, employees, and/or agents from any and all claims arising out of the connection with any use of the materials, caption information, and images described above, including any and all claims for libel, defamation, and/or invasion of privacy or unwanted publicity.
Liability Waiver (Student 1)
Safety is always the first priority in the PCYF Sailing Program. To minimize the chance of injury, PCYF personnel check the boats, docks, and training area daily for hazards and eliminate such hazards by repairing and/or reporting to the appropriate person or agency. Sailing is a physical water-based activity with inherent risks, which will be pointed out to Students during the Program and through adherence to the Behavioral Rules and Guidelines (below). Stubbed toes, bumps, bruises, splinters, and more serious injuries, including possible death, may occur from tripping or falling on the docks or in the training facility, improper use of boats, rough-housing, running on the docks, or other causes. On behalf of myself and the Student, I agree, to make no claims against the County of Ventura, including all departments, agencies, and employees associated with the County of Ventura, or against Pacific Corinthian Youth Foundation (PCYF) or any of its officers, directors, members, agents, employees, or associated yacht clubs, including, but not limited to, Pacific Corinthian Yacht Club (PCYC), for any loss of, or damage or injury to any person or persons, including the Student, or property, and to protect and indemnify PCYF and its officers, directors, members, agents, employees, or associated yacht clubs, including, but not limited to, PCYC, against liability for any loss, damage, or injury caused or incurred by the Student.
Behavioral Rules and Guidelines (Student 1)
The Pacific Corinthian Youth Foundation (PCYF) Summer Sailing Program is built around the US Sailing Association’s philosophy of “safety, fun, learning,” that is, safety first to enhance Students’ fun and learning. These Behavioral Rules and Guidelines are intended to assure a safe, rewarding, and fun learning environment for all Students. It is important for the Student and Parent/Guardian to review and agree to obey these Rules and Guidelines together before the first class. The consequences of not following them will vary with the infraction, ranging from “time out,” temporary loss of privileges, to suspension from the program. A second incident will result in the Student’s dismissal for the remainder of the session with no refund of tuition fees.
Students must comply with the following Behavioral Rules and Guidelines. Review each item with the Student and check the box to confirm the Student's understanding:
*
1. All Students, parents, guardians, Instructors, and representatives of PCYF are expected to comply with all CDC, state, and local health guidelines in effect at the time of each session.
2. On the first day of class all first-time Students must take a short swimming test, consisting of laps in a pool, treading water, and putting on a USCG-approved lifejacket while in the water.
3. Shirts, shorts, and closed-toe shoes, sandals, or other foot protection approved by an Instructor shall be worn on the premises at all times.
4. Lifejackets (“PFDs”) shall be worn at all times when the Student is on the dock or in a boat. Swimming attire is acceptable at the pool, on the dock, or in a boat.
5. Students are responsible for their own hydration and sun protection – at a minimum, water bottle, hat, sunscreen, and sunglasses.
6. Students are expected to properly dispose of their own trash and keep their belongings together in a neat and orderly fashion.
7. In support of team responsibility for derigging the boats at the end of each day, Students will not be allowed to leave until their boats and related equipment have been properly stored.
8. Students are expected to show respect for their peers, the Instructors, and others; obey the Instructors; and observe Instructor-established boundaries at all times.
9. Students shall not run on the dock; climb on the boat racks, trailers, dock, or rocks near shore; throw objects at others; use obscene language; nor display any other behavior that is disruptive or otherwise interferes with the conduct of daily classes.
10. Bullying will not be tolerated. Verbal or physical abuse as well as any behavior that jeopardizes the Student’s or another’s safety will result in early dismissal for the day and a warning to the Student and Parent/Guardian.
Parent/Guardian Signature: By signing this form I hereby certify that I am the Parent/Legal Guardian of Student 1, who is between 8 and 18 years old during the current calendar year, weighs at least 40lbs, and can swim at least 15 yards. I have read the Visual Media Consent and Liability Waiver above and fully understand the contents, meaning, and impact. I hereby acknowledge that I have discussed all the Rules and Guidelines above with this Student, and s/he agrees to comply with them. I realize that I cannot withdraw my consent after signing and that this release is binding on me and my heirs, legal representatives, and assigns.
*
Date
/
Month
/
Day
Year
Today's Date
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Would you like to enroll a second student?
*
Yes
No
Student 2 Information
Student 2 Name
*
First Name
Last Name
Date of Birth (eligible between 01/01/2006 and 12/31/2016)
*
/
Month
/
Day
Year
Date
Gender
*
Male
Female
N/A
Student's Home Town
*
City and State (or Country, if outside the US)
Sailing Skill Level
*
Please Select
Beginner
Advanced Beginner
Intermediate
Advanced
Is Student 2 registering for a single session or multiple sessions?
*
Single
Multiple
1st Choice Session
Please Select
Session 1 - June 17-28, 2024
Session 2: July 1-12, 2024
Session 3: July 15-26, 2024
Session 4: July 29-August 9, 2024
2nd Choice Session
Please Select
Session 1 - June 17-28, 2024
Session 2: July 1-12, 2024
Session 3: July 15-26, 2024
Session 4: July 29-August 9, 2024
Select each session Student 2 wishes to attend:
Session 1: June 17-28
Session 2: July 1-12 (no class July 4; make-up day upon request)
Session 3: July 15-26
Session 4: July 29-August 9
Additional Comments regarding your session choices:
Does Student 2 have any medical conditions, such as allergies, hyperactivity, eyeglasses/contact lenses, sun sensitivity, injuries, or physical or learning disabilities?
*
No
Yes
Please elaborate on the Student 2's medical condition(s), medications (if any), and concerns to share with the PCYF Instructor:
In the event of a Medical Emergency, PCYF will attempt to contact the individuals listed as Emergency Contacts. As an additional emergency contact, please provide the Student's Physician/Medical Group Name, City, and Phone Number:
Visual Media Consent (Student 2)
I give Pacific Corinthian Youth Foundation (PCYF) permission to make photographs, videotapes, films, or other likenesses of my child/legal ward and me. I hereby grant PCYF the unrestricted right to copyright any of the above-mentioned materials containing images of us as well as the unrestricted right to use and reuse them, with their caption information, in whole or in part, in any manner, for any purpose, and in any medium now known or hereinafter invented, in perpetuity, and in all languages throughout the world. These rights include, but are not limited to, the right to publish, copy, distribute, alter, license, and publicly display these materials for editorial, trade, marketing, and/or advertising purposes. I also grant PCYF and its licensees the unrestricted right to use and disclose our names in connection with the use of the above materials. I understand and agree that we will not be paid for any use described above. I also waive, release, and discharge PCYF, its officers, employees, and/or agents from any and all claims arising out of the connection with any use of the materials, caption information, and images described above, including any and all claims for libel, defamation, and/or invasion of privacy or unwanted publicity.
Liability Waiver (Student 2)
Safety is always the first priority in the PCYF Sailing Program. To minimize the chance of injury, PCYF personnel check the boats, docks, and training area daily for hazards and eliminate such hazards by repairing and/or reporting to the appropriate person or agency. Sailing is a physical water-based activity with inherent risks, which will be pointed out to Students during the Program and through adherence to the Behavioral Rules and Guidelines. Stubbed toes, bumps, bruises, splinters, and more serious injuries, including possible death, may occur from tripping or falling on the docks or in the training facility, improper use of boats, rough-housing, running on the docks, or other causes. On behalf of myself and the Student, I agree, to make no claims against the County of Ventura, including all departments, agencies, and employees associated with the County of Ventura, or against Pacific Corinthian Youth Foundation (PCYF) or any of its officers, directors, members, agents, employees, or associated yacht clubs, including, but not limited to, Pacific Corinthian Yacht Club (PCYC), for any loss of, or damage or injury to any person or persons, including the Student, or property, and to protect and indemnify PCYF and its officers, directors, members, agents, employees, or associated yacht clubs, including, but not limited to, PCYC, against liability for any loss, damage, or injury caused or incurred by the Student.
Behavioral Rules and Guidelines (Student 2)
The Pacific Corinthian Youth Foundation (PCYF) Summer Sailing Program is built around the US Sailing Association’s philosophy of “safety, fun, learning,” that is, safety first to enhance Students’ fun and learning. These Behavioral Rules and Guidelines are intended to assure a safe, rewarding, and fun learning environment for all Students. It is important for the Student and Parent/Guardian to review and agree to obey these Rules and Guidelines together before the first class. The consequences of not following them will vary with the infraction, ranging from “time out,” temporary loss of privileges, to suspension from the program. A second incident will result in the Student’s dismissal for the remainder of the session with no refund of tuition fees.
Students must comply with the following Behavioral Rules and Guidelines. Review each item with the Student and check the box to confirm the Student's understanding:
*
1. All Students, parents, guardians, Instructors, and representatives of PCYF are expected to comply with all CDC, state, and local health guidelines in effect at the time of each session.
2. On the first day of class all first-time Students must take a short swimming test, consisting of laps in a pool, treading water, and putting on a USCG-approved lifejacket while in the water.
3. Shirts, shorts, and closed-toe shoes, sandals, or other foot protection approved by an Instructor shall be worn on the premises at all times.
4. Lifejackets (“PFDs”) shall be worn at all times when the Student is on the dock or in a boat. Swimming attire is acceptable at the pool, on the dock, or in a boat.
5. Students are responsible for their own hydration and sun protection – at a minimum, water bottle, hat, sunscreen, and sunglasses.
6. Students are expected to properly dispose of their own trash and keep their belongings together in a neat and orderly fashion.
7. In support of team responsibility for derigging the boats at the end of each day, Students will not be allowed to leave until their boats and related equipment have been properly stored.
8. Students are expected to show respect for their peers, the Instructors, and others; obey the Instructors; and observe Instructor-established boundaries at all times.
9. Students shall not run on the dock; climb on the boat racks, trailers, dock, or rocks near shore; throw objects at others; use obscene language; nor display any other behavior that is disruptive or otherwise interferes with the conduct of daily classes.
10. Bullying will not be tolerated. Verbal or physical abuse as well as any behavior that jeopardizes the Student’s or another’s safety will result in early dismissal for the day and a warning to the Student and Parent/Guardian.
Parent/Guardian Signature: By signing this form I hereby certify that I am the Parent/Legal Guardian of Student 2, who is between 8 and 18 years old during the current calendar year, weighs at least 40lbs, and can swim at least 15 yards. I have read the Visual Media Consent and Liability Waiver above and fully understand the contents, meaning, and impact. I hereby acknowledge that I have discussed all the Rules and Guidelines above with this Student, and s/he agrees to comply with them. I realize that I cannot withdraw my consent after signing and that this release is binding on me and my heirs, legal representatives, and assigns.
*
Date
/
Month
/
Day
Year
Today's Date
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Household Information
Please provide the names and contact information for up to 2 adults who will be involved in the student's participation in PCYF Summer Sailing Camp.
Adult Contact (1)
*
First Name
Last Name
Adult Email (1)
example@example.com
Phone Number (Adult 1)
*
Please enter a valid phone number.
Roles and Relationship to Student (Adult 1) - Select all that apply
*
Parent/Guardian
Grandparent
Aunt/Uncle
Adult Friend
Primary Emergency Contact
Secondary Emergency Contact
Registration
Payment of Fees
Student Pick-up/Drop Off
Other
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Would you like to enter contact information for a second adult?
*
Yes
No
Adult Contact (2)
*
First Name
Last Name
Adult Email (2)
example@example.com
Phone Number (Adult 2)
*
Please enter a valid phone number.
Roles and Relationship to Student (Adult 2) - Select all that apply
*
Parent/Guardian
Grandparent
Aunt/Uncle
Adult Friend
Primary Emergency Contact
Secondary Emergency Contact
Registration
Payment of Fees
Student Pick-up/Drop Off
Other
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Would you like to enter contact information for a third adult?
*
Yes
No
Adult Contact (3)
*
First Name
Last Name
Adult Email (3)
example@example.com
Phone Number (Adult 3)
*
Please enter a valid phone number.
Roles and Relationship to Student (Adult 3) - Select all that apply
*
Parent/Guardian
Grandparent
Aunt/Uncle
Adult Friend
Primary Emergency Contact
Secondary Emergency Contact
Registration
Payment of Fees
Student Pick-up/Drop Off
Other
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Reservation, Cancellation Policy, and Fee Payment
Reservations will be confirmed by email and only after payment has been received or a scholarship request has been accepted.
Cancellation Policy
If you must cancel, please notify us by email at PCYFsailing@gmail.com or by phone at (805) 974-0059 as soon as possible. Staff planning is based on the number of Students registered in each session. Places held for no-shows and late cancellations are often difficult to refill on short notice. Cancellations at least 30 days before the session starts receive a full refund, 15 - 29 days before receive 75% refund, 1 - 14 days before receives 50% refund. No refunds are available after the session starts.
The fee per student for each 2-week session is $600. Select one of the following options for registration fee payment. Details regarding payment will be provided after you submit this form:
*
1. Zelle ($600/session - no transaction fee)
2. Check ($600/session - no transaction fee)
3. PayPal/Credit Card ($620/session includes $20 transaction fee) -
4. Cash ($600 -no transaction fee)
5. Scholarship Request - The Student and Parent/Guardian must complete and submit the Scholarship Request Form, which will appear next when this option is selected.
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Scholarship Request (Student 1)
To apply for a scholarship, the Student and the Parent/Guardian must each complete their portions of this Scholarship Request form and submit it with the Student’s 2024 Summer Sailing Program Application. PCYF will contact the Parent/Guardian if further information is needed and whether a scholarship will be awarded.
Student 1 Name
First Name
Last Name
Student Portion: In your own words please explain why YOU would like to participate in the PCYF Summer Sailing Program:
*
Parent/Guardian Portion: Please explain the Student’s need for financial assistance
*
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Is a second student also requesting a scholarship?
*
Yes
No
Scholarship Request (Student 2)
To apply for a scholarship, the Student and the Parent/Guardian must each complete their portions of this Scholarship Request form and submit it with the Student’s 2024 Summer Sailing Program Application. PCYF will contact the Parent/Guardian if further information is needed and whether a scholarship will be awarded.
Student 2 Name
First Name
Last Name
Student Portion: In your own words please explain why YOU would like to participate in the PCYF Summer Sailing Program:
*
Parent/Guardian Portion: Please explain the Student’s need for financial assistance
*
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Application Date
*
/
Month
/
Day
Year
Today's Date
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Submit
Should be Empty: