2017 BYC Race Team Registration Form Bellingham Yacht Club Race Team 2017 Medical Waiver and Team Registration form. Step 1 of 2 50% Applicant InformationName*Enter name of the youth applicant. First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Cell/Emergency Phone*Primary Contact Phone Number (Daytime)Birth Date*Min. Age - 8 yrs. MM DD YYYY Weight(Pounds)Email*Primary Contact Email Enter Email Confirm Email SchoolName of Applicant's SchoolSailing Experience*Choose appropriate experience level.BeginnerIntermediateAdvancedSwimming Experience*Choose appropriate experience level.BeginnerIntermediateAdvancedAllergies and/or Relevant Medical Conditions of Concern:(Diabetes, Epilepsy, Heart Disease and history of Hypothermia are generally considered relevant to cold water sports.)Contact InformationParent/Guardian Name* Daytime Phone*Evening Phone*Parent/Guardian Name Daytime PhoneEvening PhoneEmergency Contact Name Daytime PhoneEvening PhoneEmergency Contact Name Daytime PhoneEvening PhoneApplicant's Physician Daytime PhoneApplicant Acceptance/AcknowledgementI, the above-named Applicant, do hereby agree to adhere to the bylaws, rules and/or policies of the Bellingham Yacht Club. I understand that my failure to do so will jeopardize my ability to continue to participate in Club activities, including training and racing. I agree to treat Club property, including boats, with care and to follow all safety and other practices required by the Club, its officers, trustees, volunteers or employees. By joining the race team you are also eligible to become a Junior Instructor. Being a JI helps you attain the knowledge and practical skills useful for becoming a certified instructor under the direction of our current instructor team. Contact the Youth Sailing Director for more information.Acceptance* I accept the above statement. Acceptance Date* Parent/Guardian Approval/WaiverThe Parent/Guardian of the Student is required to read the "Release of Liability, Waiver of Right to Sue and Agreement to Indemnify and Hold Harmless" document and print and sign a copy of the document and return it to the BYC. The signed copy of the waiver must be received by the BYC before the student can participate in any class. The waiver can be brought to the first day of class. If the Parent/Guardian is registering more than one student, a copy of the waiver must be submitted for each student. I also agree to allow use of any photos taken of the participant during the class to be used for Bellingham Yacht Club promotional purposes, including, but not limited to use on the BYC website and promotional flyers.Parent/Guardian* Acceptance* I accept the above statement. Date* How did you hear about us?*Family or FriendBellingham Leisure GuidePosterOtherOther 2017 BYC Youth Race Team Registration 2017 Opti and Advanced Team Membership Options Sessions run weekly starting June 26th thru August 18th Level 1 - Advanced Race Membership - Opti/FJ/Laser/29er $250 Laser/29er practice - Mondays and Thursdays, Noon to 4:00 p.m. Opti/FJpractice - Mondays and Thursdays, 4:30 p.m. to 7:00 p.m. Team members must be there 1/2 hour ahead of practice times to rig boats and warm up. All Level 1 Classes include Tuesday Night Dinghy Racing - first start is at 6:00 p.m. til 8:00 p.m. with boat rigging at 4:30 p.m. and coaching support for all NWYRC summer regatts (race entry and travel not included). Level 2 Race Team Membership $475 (a $25 savings) Level 1 plus your choice of one 5-day race clinic (June19-23 or July 31-August 4). Level 3 Race Team Membership $650 (a $100 savings) Level 1 plus both 5-day race clinics (June19-23 or July 31-August 4). BYC Youth Race Team Selection*Level 1 = 6 weeks of Monday and Thursday practices, Tuesday Night Dinghy Racing and coaching at NWYRC summer regattas. Level 2 = Level 1 plus your choice of 1 of 2 five-day Race Clinics (June 19-23 or July 31-Aug. 4) Level 3 = Level 1 plus both five-day Race Clinics (June 19-23 and July 31-Aug. 4)2017 L-1 Advanced Team Opti/FJ/Laser/29er - $2502017 L-2 Advanced Team Opti/FJ (June 19-23 clinic) $4752017 L-2 Advanced Team Opti/FJ (July 31-Aug. 4 clinic) $4752017 L-3 Advanced Team Opti/FJ/Laser/29er (both clinics) $6502017 L-1 Advanced Team Opti/FJ/Laser/29er Registration Price: $250.00 2017 L-2 Advanced Team Opti/FJ/Laser/29er Registration (June 19-23 Clinic) Price: $475.00 2017 L-2 Advanced Team Opti/FJ/Laser/29er Registration (July 31-Aug. 4 Clinic) Price: $475.00 2017 L-3 Advanced Team Opti/FJ/Laser/29er Registration (both clinics) Price: $650.00 Optional Clinic/Team Practices Special 4-Day Pre-NW USODA Champs Opti Clinic Pre-Summer Laser Team - Thursday Practice (June 1) Pre-Summer Laser Team - Friday Practice (June 9) Pre-Summer Laser Team - Friday Practice (June 16) Pre-Summer 29er Team - Monday Practice (June 5) Pre-Summer 29er Team - Monday Practice (June 12) Special 4-day Pre-NW USODA Champs Opti ClinicOpti Sailors Only Price: $200.00 Pre-Summer Laser - Thursday Team Practice (June 1) Price: $20.00 Pre-Summer Laser - Friday Team Practice (June 9) Price: $20.00 Pre-Summer Laser - Friday Team Practice (June 16) Price: $20.00 Pre-Summer 29er - Monday Team Practice (June 5) Price: $20.00 Pre-Summer 29er - Monday Team Practice (June 12) Price: $20.00 Total $0.00 Payment Option*Select Payment Option. Do not send cash by mail.Credit Card via PayPal (PayPal membership not required)Charge to BYC Account (Members only)Mail CheckPayment Options Payments are accepted by check, credit card via PayPal (PayPal membership is not required) or for BYC members, charged to your BYC account.. If paying by mail, print a copy of this application before submitting it and send it along with your payment to: BYC Youth Race Team Registration Bellingham Yacht Club 2625 S. Harbor Loop Drive Bellingham, WA 98225 For questions regarding this form or about the Youth Race Team contact Gavin Brackett at (360) 317-8249, email: email@example.com NOTE: BEFORE SUBMITTING THIS FORM WE SUGGEST THAT YOU PRINT A COPY FOR YOUR RECORDS. This iframe contains the logic required to handle AJAX powered Gravity Forms.