Sailing Camp Registration Form
*Your child must be comfortable in the water in a life jacket and able to swim 10m.*
Sailor's Information
(One form per sailor)
Sailor Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Associated Cottage Site Number
*
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
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5
6
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31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
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1920
Year
Age (at camp)
*
Please Select
5
6
7
8
9
10
11
12
13
14
15
T-Shirt Size
Youth S
Adult S
Youth M
Adult M
Youth L
Adult L
Adult XS
Adult XL
List Any Allergies
Parent / Guardian Information
(All correspondence will be with this person)
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Phone
*
Cottage Phone Number
Emergency Contact at the Bay
Name (EMERG)
*
First Name
Last Name
Email (EMERG)
*
example@example.com
Phone Number (EMERG)
*
Program Information
Select Camp Week(s)
*
July 8th
July 29th
July 15th
August 5th
July 22nd
August 12th
Current Sailing Level
*
Beginner/CANSail 1
CANSail 3
CANSail 2
CANSail 4
Swimming Ability
*
Basic (comfortable in water in a lifejacket, and can swim 10m)
Moderate (very comfortable in water and can swim short distances with ease)
Advanced (basically a fish)
Payment Information
Please fill in all fields below
*
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( X )
Number of weeks you are participating
$325 per week.
$
325.00
CAD
Number of Weeks
1
2
3
4
5
6
Item subtotal:
$
0.00
CAD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Waiver
I understand that it is a condition of participating in this program that the participant and their parent/guardian do so at their own risk. Therefore in consideration of acceptance of entry into this program, I agree to save harmless and keep indemnified The Madawaska Club Limited, and The Madawaska Club at Go Home Bay, the organizers and their respective agents, officials, servants and representatives from and against all claims, actions, costs, expenses and demands in respect to death, injury, loss or damage to person or property, howsoever caused, arising out of or in connection with taking part in this program. I further understand and agree that this release is binding upon myself, my heirs, executors and assigns. I understand that photographs and videos taken of program participants and staff may be used for promotional purposes and I hereby consent to such by The Madawaska Club at Go Home Bay.
*
I have read and accept the terms of the waiver
Date
*
-
Month
-
Day
Year
Signature
*
Any Comments or Questions?
Submit
Should be Empty: