Blessington Sailing Club Junior Sail Training Courses

 

APPLICANTS’S NAME: _________________________________  DATE OF BIRTH:  ________________

ADDRESS:  _______________________________________________________________________________

PARENT’S DAYTIME TELEPHONE NUMBER  (In case of emergency): ___________________________

 

An existing Junior Member        

A friend of a Junior Member      

Text Box: CLASS OF MEMBERSHIP: Child of a Family Member           An existing Junior Member         A friend of a Junior Member               3rd         
        2nd                  4th          Text Box:         I.S.A. STAGES PASSED                         (Please tick)         1st                   3rd                  2nd                  4th         

 

 

 

 

I WISH TO APPLY FOR A PLACE ON (please tick your selection)

ISA STAGE:

 

 

€

 

Level 1

2 week course

Optional 3rd week

4 July – 15 July

18 July – 22 July

180

90

 

 

Level 2

2 week course

Optional 3rd week

4 July – 15 July

18 July – 22 July

180

90

 

             

Level 3

3 week course

4 July – 22 July

270

     

Level 4 (Racing Skills)

3 week course

4 July – 22 July

270

     

 

Text Box: INSURANCE COMPANY: _________________________    POLICY  NO:  _________________________

 

Text Box: CLASS OF BOAT: ___________________________ (Leave blank if intending to buy a boat)   SAIL  NO:  ___________________________

 

                                                                                                        

  

 

 

DECLARATION to be signed by the Parent or Guardian

I wish my child to enter for a Junior Sail Training Course.  I agree to abide by the decisions of the committee in matters relating to the course.  I have no objection to the boat being used under proper supervision for the purpose of the course.  I further agree to waive any claim against Blessington Sailing Club, its members and servants, for any loss or damage to my property or my child’s property or for any personal injury to me or to my child arising from the course.

Signature: ______________________________________________________________________________

Forms to be returned ONLY to Peter Dolan, Junior Organiser, 8 Templeroan Crescent, Dublin 16, together with a non-refundable deposit of €30 per child, with the balance to be paid before 28 May 2005.  Places will be allotted on a “first come – first served” basis.