Saturday "SYSTEM" Sailing 2025-2026

"SYSTEM" Sailing+Youth+STEM Program Application

Saturdays from 10:00 to 3:00 -- January 3 to February 21, 2026
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*

MaleFemale
Sailor's Race (choose all that apply)*

CaucasianHispanic/Latino/SpanishAfrican AmericanNative Hawaiian/Pacific IslanderAsianAlaskan NativeMiddle EasternHow I Identify is Not Represented HerePrefer Not to Say
How Would You Rate Sailor's Water Comfort?*

Non swimmerLow level of water comfortCompetent swimmer and comfortable in waterHighly competent swimmer
Prior Sailing Experience*

NoneFrom Team Paradise SailingFrom another sailing programFrom sailing with family and friends
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*

Less than $25,000$26,000 - $50,000$51,000 - $75,000$76,000 - $100,000Over $100,000
Household Info.*

Two-Parent HouseholdSingle-Parent HouseholdCustodial Grandparent/Guardian
Does Your Sailor Receive financial aid from county, the state or federal government? (Documents must be made available for those seeking a scholarship.)*

Yes (a scholarship application will be sent on a space-available basis)NoPrefer Not to Answer
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