web APPLICATION FOR DCSS JUNIOR SAILING PROGRAM 2008

Week starting: 1st choice_______2nd choice_______3rd choice_______

Statement to be signed by Junior sailor:

I understand that a violation of safety regulations and or failure to comply with instructions of the teaching staff or their assistants will be grounds for dismissal from the program. I agree to practice safe boating at all times and to wear a life vest whenever I am on or near the water.

Junior Sailor Name (please print)_________________________________________

Junior Sailor signature _______________________________date_______________

Number of seasons sailing experience _____________________________________

PARENT/GUARDIAN CERTIFICATION

I give permission for _________________________ age ____, to participate in the Junior Sailing program of the Deep Creek Sailing School. I hereby agree to hold the Deep Creek Sailing School, its officers, board members, the instructors, and their volunteer helpers harmless from any claim for loss or injury for any reason whatsoever during or in conjunction with this sailing program. We understand that our child will be sailing on Deep Creek Lake and we and our child assume the risk of this experience.

Parent/Guardian signature_______________________________________________

Parent/Guardian name (please print)_____________________________________

Address_____________________________________________________________ ____________________________________________________________________

Lake Phone _____________________Home Phone__________________________

e-mail ____________________________Cell Phone_________________________

Permission to use your child's photograph in our web page: _______Yes _______ No

Tuition @ $235 for one student ______________

Tax deductible contribution to Deep Creek Sailing School ______________

Total (Make checks payable to Deep Creek Sailing School) ______________

Send application, medical form, and check to:

Deep Creek Sailing School,  Inc.
365 Back Bay Road, Swanton, MD 21561