Saturday "SYSTEM" Sailing 2026-2027

"SYSTEM" Sailing+Youth+STEM Program Application

Saturdays from 10:00 to 3:00
Sailor's Name

First NameLast Name
Sailor's Nickname (if any)?
Sailor's Email Address
example@example.com
Sailor's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent or Guardian #1 Name

First NameLast Name
Parent or Guardian #1 Cell Phone Number

Area CodePhone Number
Parent or Guardian #1 E-Mail Address
example@example.com
Parent or Guardian #2 Name

First NameLast Name
Parent or Guardian #2 Cell Phone Number

Area CodePhone Number
Parent or Guardian #2 E-Mail Address
example@example.com
Emergency Contact (Someone Other Than Parent/Guardian)

First NameLast Name
Emergency Contact's Relationship to Sailor
Emergency Contact Phone Number

Area CodePhone Number
Sailor's Birthdate (Must be between the age of 9 and 13)

MonthDayYear
Date
Sailor's Height (ft. in.)
Sailor's Weight (lbs.)
Allergies: List allergies*
Medical Conditions we Should be Aware of: List medical conditions*
Intellectual or Developmental Conditions: List any cognitive/intellectual conditions that might interfere with sailor's ability to follow instruction*
Sailor's Gender
Sailor's Race (choose all that apply)
How Would You Rate Sailor's Water Comfort?
Prior Sailing Experience
Name of School Sailor Attends. If sailor is home schooled, please indicate.Name of School or, if home schooled, fill in the blank with "home school"*
Household Income
Household Info.
Is there anything else you would like us to know about Sailor? (For example, intellectual, behavioral, cognitive or physical ability information.)
How did you hear about us?
Should be Empty:

"SYSTEM" Sailing+Youth+STEM Program Application