LJM Maritime Academy

LJM Maritime Academy
Summer Camp
Ages: 10-15
July 13 - July 24, 2026
REGISTRATION FORM
Please print or type all the information requested below. If you are to be considered for 2025, you must provide all requested information. Your parent's (legal guardian) signature is required.
DEADLINE FOR APPLICATION – June 19, 2026 at 5pm.
1. STUDENT NAME

First NameMiddle InitialLast Name
2. ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
3. TELEPHONE:
Format: (000) 000-0000.
SEX:
4. SCHOOL NAME:
5. DATE OF BIRTH (DD/MM/YY):

MonthDayYear
Date
(PROVIDE COPY OF YOUR PASSPORT)
6. MOTHER'S NAME:
7. HOME/MOBILE NO.:
Format: (000) 000-0000.
8. EMAIL ADDRESS.:
example@example.com
9. FATHER'S NAME:
10. HOME/MOBILE NO.:
Format: (000) 000-0000.
11. EMAIL ADDRESS:
example@example.com
12. PARENT/LEGAL GUARDIAN'S SIGNATURE:
13. STUDENT'S FUTURE CAREER CHOICE
14. REASON FOR CHOICE
PLEASE SELECT T-SHIRT SIZE ADULT SIZES:
Date:

MonthDayYear
Date

LJM Maritime Academy

Summer Camp July 13 - July 24, 2026
MEDICAL PERMISSION FORM
The undersigned, as parent or legal guardian of
Student Name
gives consent for the above-named student to participate in all activities, including field trips.
In the event that medical treatment is required, the undersigned parent or guardian consents to finance any and all payments for medical treatment, which may be deemed advisable by a qualified physician selected by any agent or official of L.J.M. Maritime Academy.
I hereby release and hold harmless L.J.M. Maritime Academy, its employees and agents from action arising from the camp.
I authorize L.J.M. Maritime Academy, in case of emergency, to take my child to
(Doctor's Name)
(Institution & Telephone No.)
EMERGENCY CONTACT: (Other than parent(s) or legal guardian)
NAME
RELATIONSHIP
TELEPHONE (HOME) / (MOBILE)
Format: (000) 000-0000.
TELEPHONE (BUSINESS)
Format: (000) 000-0000.
PARENT OR LEGAL GUARDIAN
DATE

MonthDayYear
Date
TELEPHONE (HOME)
Format: (000) 000-0000.
TELEPHONE (BUSINESS or MOBILE)
Format: (000) 000-0000.
For Academy's Personnel Use Only
Date:

MonthDayYear
Date

Please answer all questions.

Rows	Yes	No	If 'Yes', Please Comment
A) Diseases or disorders of the eyes, ears, nose or throat
B) Dizziness, fainting convulsions, speech defect
C) Mental or nervous disorders
D) Shortness of breath, asthma
E) High blood pressure
F) Rheumatic fever
G) Kidney disease
H) Diabetes
I) Rheumatism, arthritis or disorder of muscles or bones
J) Deformity, lameness or amputation
M) Disease of the skin
N) Anemia
Heart Problem

2. Do you have any allergies to food, medicine, insect bites, other?
3. Females only: Do you suffer from severe, painful menstruation?
4. Do you have medical insurance?
Do you know of or suspect anything adverse about your Child's health, which may limit participation in any of the activities of the sailing programme?
If yes, explain:
Signature of Parent/Legal Guardian:
Date:

MonthDayYear
Date

LJM MARITIME SUMMER CAMP PERMISSION SLIP
I/ We,
grant permission for my child,
to attend All Sailing Camp Off Campus Events & Activities. (Bahamas National Sailing School) with the supervised LJMMA Sailing Camp Coordinator(s).
I/We understand all reasonable safety precautions will be taken by LJM Maritime Academy personnel and its instructors during the events and activities.
I/we authorize treatment deemed necessary by an accredited medical practitioner in case of an emergency.
I/We understand the possibility of unforeseen hazards and know the inherent possibility of risk.
I/We agree not to hold LJM Maritime Academy, its leaders, employees and volunteer staff liable for damages losses, diseases, or injuries incurred by the subject of this form.
Parent/ Guardian, (Printed Name):
Signature:
1. Emergency Contact:
Format: (000) 000-0000.
1. Emergency Contact:
Format: (000) 000-0000.
Endorsement of LJMMA
MARITIME CAY P.O.BOX N-10455 TEL: (242) 397-5300

LJM MARITIME ACADEMY
INDEMNITY FORM
LJMMA INDEMNITY BOND
Name of Student
Programme:
I, the undersigned Parent/Guardian
of
Hereby indemnify the L.J.M. Maritime Academy and its Board, administrators, staff, and faculty from any claim whatsoever arising out of personal injury or death to the undersigned due to any accident during the period of training.
Undertaking
I hereby undertake to pay the amount for any intentional damage caused by the undersigned to any property of the training facilities (for example, books, chairs, computers , boat parts, and simulators) during the period of training.
Name:
Signature:
Date:

MonthDayYear
Date
MARITIME CAY • P.O.BOX N-10455 • TEL: (242) 397-5300
I confirm that all information submitted in this application is accurate and complete.
Should be Empty:

Summer Camp