Name: 420 One-Week
Price: 684.00 USD
Availability: InStock

Prerequisites: Sailing Director must have approved slot in this program.

$484 for Program

+$200 for Non-Member, Junior Use Permit

Description

Please ensure you have received approval from the sailing director before paying.

Junior Use Permit: This $200 fee is required for all non-members for use of the club. If you are a member, please log in to automatically receive discount.

More information about key program dates & class schedules can be found here.

Please have your child’s health insurance, doctor’s name, phone number, and your payment info ready before you begin.

Week

Clear

Sailor Information
Sailor Name*
First Last
Sailor T-Shirt Size
- X-Small
- Small
- Medium
- Large
- XL
- XXL
Sailor Birthdate*
Month
Day
Year
Required Swim Test
I hereby confirm that my child can swim 50 yards. A SWIMMING TEST WILL BE ADMINISTERED BEFORE A STUDENT CAN START LESSONS.

I am the parent/guardian of the student named above. I understand and accept that the sport of sailing and the conduct of a Sailing Program are subject to certain inherent risks. For myself and the student listed above, I accept all risk on land and on water, of participation on the Program.

I agree to waive, to the fullest extent permitted by the law, any claims against the Orient Yacht Club or any of its directors, Officers, members, employees or agents in relation to any loss, injury, or damage, on land or water, to the student named above or to the boat or other property of the undersigned or the student named above.

I agree to defend and indemnify the Orient Yacht Club, its officers, directors, members, employees and agents against the expense of or liability for any loss, claims of loss, damage or injury caused by the negligence, misconduct or failure to exercise reasonable care by the student named above.

I agree to make sure the student abides by the rules of the Sailing Program, and I understand that the student could be suspended for failure to attend regularly, arrive promptly, or obey the rules. I agree to attend a Parent-Instructor conference if requested.

I agree to reimburse the Orient Yacht Club for damages above and beyond normal wear and tear to any club boat which is caused by the negligence, misconduct or failure to exercise reasonable care by the student named above.
Consent (Above Reading Required)*
I confirm my child can swim 50 yards.
Parent/Guardian Information
Parent 1*
Phone 1*
Email 1*
Parent 2*
Phone 2*
Email 2
Additional Contacts
In the event of an emergency, we will always contact the parents/guardians first. This (optional) section is for an additional person you'd like listed as your child's emergency contact.
Emergency Contact
Phone
Relationship to Sailor
Medical Information
Sailor's Physician*
Physician's Phone*
Health Insurance Company*
Policy Number*
Date of Last Tetanus Shot*
Month
Day
Year
Allergies or Other Medical Information:*
Waiver*
I hereby authorize an instructor from my Club or Program, or an adult who bears this document, to authorize emergency treatment for the Junior Sailor named above in the event that a parent or legal guardian cannot be reached at the above telephone numbers at the time of the emergency.
Session*
Please confirm.
- First Half (June 28 - July 23)
- Second Half (July 26 - August 20)
- Full Summer (June 28 - August 20)
- One Week
Which Week?
- First Week (June 28 - July 2)
- Second Week (July 5 - 9)
- Third Week (July 12 - 16)
- Fourth Week (July 19 - 23)
- Fifth Week (July 26 - 30)
- Fifth Week (August 2 - 6)
- Sixth Week (August 9 - 13)
- Seventh Week (August 16 -20)
Program Waiver and Indemnity
The undersigned is the parent/guardian of the Junior Sailor named above and hereby acknowledges that the execution of this Agreement is a condition to the participation of the Junior Sailor in his/her own Junior Sailing Program (hereinafter referred to as the “Program”) as stated below.
The undersigned accepts that the sport of sailing and the conduct of the Program entail and are subject to certain inherent risks, and, on behalf of the Junior Sailor, accepts all risks on land and at sea of participation in the Program. Now, therefore, the undersigned does hereby agree as follows:

1. The undersigned consents to the participation of the Junior Sailor in the Program and agrees that this will extend to Orient Yacht Club.

2. The undersigned consents to the participation of the Junior Sailor in all regattas, clinics, and sailing events (hereinafter collectively referred to as “Regattas”) which are a part of the Program and acknowledges that said consent is without exception within the limits proscribed within, unless a specific exception is noted herein. The undersigned further agrees that this Agreement will extend to the benefit of yacht clubs/ sailing associations (hereinafter referred to as “Host Clubs”) which are the host to or venue of such Regattas and to the Peconic-Gardiners Junior Sailing Association. (hereinafter referred to as “PGJSA”).

3. The undersigned waives any claims against and releases any obligation of the Club, each Host Club, the PGJSA and all of their respective members, employees, agents and all persons serving as members of the Race Committees or Juries or any other person acting in any capacity for the conduct of the program or any Regatta in relation to any loss, injury or damage, on land or at sea, to the Junior Sailor or to the boat or other property of the undersigned or the Junior Sailor to the fullest extent permitted by law.

4. The undersigned agrees to reimburse the Club, any Host Club, the PGJSA and all of their respective members, employees, agents and all persons serving as members of the Race Committees or Juries or any other person acting in any capacity for the conduct of the Program or any Regatta for any loss or damage to property, and hold the Club, each Host Club and the PGJSA harmless from any claim, loss or injury caused by the negligence, or misconduct of, or failure to exercise reasonable care by the Junior Sailor.
Waiver (Reading Required)*
I agree to the Program Waiver and Indemnity.
Guardian E-Signature*
Sailor E-Signature*

420 One-Week

Sailor Information

Required Swim Test

Parent/Guardian Information

Additional Contacts

Medical Information

Program Waiver and Indemnity