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Junior Sailing Registration

Class: 
July 5 - 9, 2005
(Tues-Sat)		   Amount Paid:
Student Name:
Address:
Address:
City: State:
 		 Zip:
Email:
Date of Birth (MM/DD/YYYY):
Boating Experience:
Parent or Guardian:
Day time Phone Numbers for above:
Other Pertaint Numbers:

* LIABILITY RELEASE *

PBYC insures its Summer Sailing Program, however its officers, employees, and volunteers assume no responsibility for the injury of persons participating in the Program. And the undersigned agrees to hold the Pensacola Beach Yacht Club, its officers, employees, and volunteers harmless because of death, illnesses or injuries sustained by this applicant.

It is understood that the Pensacola Beach Yacht Club can at any time suspend a participant from the program with just cause.

We, the undersigned parents, guardian or sponsor, hereby certify that we have given our consent to his or her participation in the PBYC Summer Sailing Program in accordance with the requirements stated
Parent or Guardian:
Date:


Note your must sign your forms before class

You can provide feedback on this website by submitting email to the webmaster or the commodore. You can mail directly to the Yacht Club at: Pensacola Beach Yacht Club, PO Box 1112, Gulf Breeze, FL 32562 - 1112. Phone (850) 934-8757. See our Location page for more information