Youth Sailing Registration Youth Sailing Registration Step 1 of 4 25% Student Name* First Last Nickname Student Birthdate Health/Other Considerations*Are there any special needs/allergies/medications/other concerns we need to be aware of?YesNoHealth/Other Considerations Details*Fill out any necessary information about Health/Other Considerations here.Member User IDIf you are already a member of CRSA, please include that here.Parent Name* First Last Parent Relation*MotherFatherGuardianParent Phone*Parent Email* Alternate Contact* First Last Alternate Contact Relation*MotherFatherGuardianAlternate Contact Phone*Alternate Contact Email* Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Permission to Participate and Release of Liability In consideration of accepting my child's or my entry, I hereby, for myself and my child, waive and release any and all rights and claims for damages my child or I may have against Cave Run Sailing Association Youth Sailing Academy; its principals, directors, officers, agents, employees, volunteers, contributors, donors, their insurers, and each and every land owner, lessee, municipal and/or government agency whose property or equipment is used to conduct any activity for the Cave Run Sailing Association and affiliates, and their insurers, if any, for any and all injuries suffered (including death) by myself or my child at any activity sponsored by these groups. I acknowledge and understand that the sailing activity I am about to participate in, or let my child participate in, is an exciting and demanding challenge and will expose us to above-normal risks to injury and harm. I agree to assume responsibility for all the risks of the activity for myself and my child. I grant permission for medical treatment to be administered to my child or myself in the event of an emergency and I assume responsibility for the expense incurred for medical attention throughout the duration of the program. I allow the use of my child's or my image in future promotional materials produced by Cave Run Sailing Association and/or the CRSA Youth Sailing Academy, for its own behalf. I have read, understand and agree to the Permissions and Release of Liability*YesNoStudent Name* First Last Parent/Guardian Name* First Last Parent/Guardian Signature* Youth Sailing Student/Parent Agreement Parent/Guardian attendance and participation is encouraged! Please make arrangements with the youth director if a student must be unattended. Stay with the class unless you have permission from the youth director to leave. Life jackets must be worn and secured at all times on dock or boats by all personnel. Close-toed shoes should be worn at all times. Respect one another - no rough play, violence, or offensive language. Respect all property - no destruction or littering on water and land. All students must participate in the set-up and take-down and storage of boats. Pay attention to overhead tree limbs and wire - stay clear. Pay attention to feet and hands/arms between boats, docks and moving parts. Use the buddy system - all sailors must sail out and return to docks together. All sailors must stay within the hailing distance of the coach boat or shore. All sailors and coach boats must return to dock upon notice. No swimming per park regulations. No jumping off boats or shore. Sailors must make every effort to avoid collisions, or stray from other boats. ASK QUESTIONS --- STAY SAFE --- HAVE FUN I have read, understand and agree to the Student/Parent Agreement*YesNoStudent Name* First Last Student Signature*Parent Name* First Last Parent Signature* PLEASE NOTE: In case on inclement weather, class cancellation or early dismissal will be at the discretion of the youth director. Students will be notified via parent or guardian email address or phone number. You may also call Chuck @ 859-270-2199 or Kelly @ 859-229-3104. Youth Sailing Fee*New Member - Fee + Student Rate $70.00Current CRSA Member $35.00Total $ 0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name CAPTCHAEmailThis field is for validation purposes and should be left unchanged.