/ Coconut Grove Sailing Club
Competitive Sailing Program
2014-2015 Registration Form /

______

Child’s Name Date of Registration Age

Please complete all lines containing fees pertaining to your sailing program. Please add your subtotals on the GRAND TOTAL line and pay this amount prior to the start of the season. Once complete please return via email to: or by fax 305 444-8959
Competitive Racing Programs
For those who have learned to sail previously and wish to train for and compete in regattas. Racers who do not own their own boat will be subject to the $150 boat usage fee. If competing in regattas, racers are subject to the $100 regatta fees to cover the costs. Additional fees may apply for more advanced racers and for regatta entry fees.
Opti Green Fleet
Course Requirements / Schedule / Price / Subtotal
Ages 6-13, Learn to Race for advanced sailors. Some travel required. / Saturdays, 9:00 AM - 4:00 PM / Members / $350.00 / $
Non-Member / $450.00 / $
Boat Usage Fee / Mandatory for those who do not own a boat / $150.00 / $
Regatta Travel Fee / Includes: local regattas, 2 regionals, and the Orange Bowl Regatta / $100.00 / $
Regatta Travel Fee if including Qualifiers / all above plus additional 2 qualifiers / $150.00 / $
Opti Green Fleet, After School
Ages 6-13, Learn to Race for advanced sailors. Some travel required. / Wednesdays, 3:30 - 6:30pm / Members / $175.00 / $
Non-Member / $175.00 / $
Regatta Travel Fee / Includes: local regattas, 2 regionals, and the Orange Bowl Regatta / $100.00 / $
Regatta Travel Fee if including Qualifiers / all above plus additional 2 qualifiers / $150.00 / $
Boat Usage Fee / Mandatory for those who do not own a boat / $150.00 / $
Opti, RWB Fleet
Ages 8-15, Fleet Racing and
Team Development / Saturdays, 9:00 AM - 6:00 PM / Members / $350.00 / $
Non-Member / $450.00 / $
Regatta Travel Fee / Includes: local regattas, 2 regionals, and the Orange Bowl Regatta / $100.00 / $
Regatta Travel Fee, Qualifiers / all above plus additional 2 qualifiers / $150.00 / $
Boat Usage Fee / Mandatory for those who do not own a boat / $150.00 / $
Opti RWB Fleet, After School
Ages 8-15, Fleet Racing and Team Development / Wednesdays, 3:30 - 6:30pm / Members / $175.00 / $
Non-Member / $175.00 / $
Regatta Travel Fee / Includes: local regattas, 2 regionals, and the Orange Bowl Regatta / $100.00 / $
Regatta Travel Fee if including Qualifiers / all above plus additional 2 qualifiers / $150.00 / $
Boat Usage Fee / Mandatory for those who do not own a boat / $150.00 / $


Sailor’s Name: ______

Competitive Racing Programs
For those who have learned to sail previously and wish to train for and compete in regattas. Racers who do not own their own boat will be subject to the $150 boat usage fee. If competing in regattas, racers are subject to the $100 regatta fees to cover the costs. Additional fees may apply for more advanced racers and for regatta entry fees.
Laser Sailing, Beginner
Course Requirements / Schedule / Price / Subtotal
Ages 13-18, Prior Experience Required / Saturdays, 9:00am - 6:00pm / Members / $350.00 / $
Non-Member / $450.00 / $
Regatta Travel Fee / Includes: local regattas, 2 regionals, and the Orange Bowl Regatta / $100.00 / $
Regatta Travel Fee if including Qualifiers / all above plus additional 2 qualifiers / $150.00 / $
Boat Usage Fee / Mandatory for those who do not own a boat / $150.00 / $
Laser Sailing, Competitive Racing
Ages 13-18, Fleet Racing and Team Development / Saturdays, 9:00 AM - 6:00 PM / Members / $350.00 / $
Non-member / $450.00 / $
Regatta Travel Fee / Includes: local regattas, 2 regionals, and the Orange Bowl Regatta / $100.00 / $
Regatta Travel Fee if including Qualifiers / all above plus additional 2 qualifiers / $150.00 / $
Boat Usage Fee / Mandatory for those who do not own a boat / $150.00 / $
Laser Sailing, Competitive Racing, After School
Ages 13-18, Fleet Racing and Team Development / Tuesdays, 4:00 PM - 7:00 PM / $175.00
Thursdays, 4:00 PM - 7:00 PM / $175.00
BOTH Tuesdays and Thursdays / Members / $350.00
Non-member / $450.00
Regatta Travel Fee / Includes: local regattas, 2 regionals, and the Orange Bowl Regatta / $100.00
Regatta Travel Fee if including Qualifiers / all above plus additional 2 qualifiers / $150.00
Boat Usage Fee / Mandatory for those who do not own a boat / $150.00
ALL FEES ARE DUE BY THE START OF THE SEASON. / GRAND TOTAL: / $
FEES ASSOCIATED WITH REGATTAS, INCLUDING BUT NOT LIMITED TO: REGISTRATIONTS, CHARTERING OF BOATS AND PERSONAL TRAVEL EXPENSES ARE NOT INCLUDED IN THE TRAVEL FEE


CREDIT CARD/ MEMBER ACCOUNT

CHARGEAUTHORIZATION FORM

Sailor’s Name: ______

PROGRAM: ______

Are you a club member? Yes No

CGSC MEMBERS ONLY: Check the box on the left to request that your fees split in 3 monthly payments. Payment in full is due no later than April 15th 2015.

SELECTING THIS OPTION EXCLUDES YOU FROM PARTICIPATING IN AUTO-PAY.

Submitting payment via check, or credit card in a timely manner is your responsibility.

AMOUNT: $______

BILL MY CGSC MEMBERSHIP ACCOUNT: YES NO

CHARGE MY CREDIT CARD: YES NO

Select your Method of Payment below:

MEMBERS ONLY: Bill my account for $ ______

CHECK: I have enclosed a check payable to: Coconut Grove Sailing Club, 2990 South Bayshore Drive, Miami, FL 33133 in the amount of: $______CHECK NUMBER: ______

CREDIT CARD: Credit Card #: ______Exp. Date: ____/_____ CVV: ______

We accept Visa, MasterCard and Discover Cards only.

Signature: ______

Refund/Cancellation Policy: In the event you must cancel your reservation, you will receive a refund the total amount minus a non- refundable $100 registration fee. Cancellation notice must be submitted in writing. Requests for cancellation due to illness or accident require a physician's written verification; upon verification, we will issue a full refund.

Authorizations and Disclosures

Child Information Parents Information

Childs First Name:
______/ Mother's Name:
______
Last Name:
______/ Father's Name:
______
Date of Birth:
______/ Father's Mobile Phone #:
______
Current Age:
______/ Mother's Mobile Phone#:
______
Gender: female male / Contact Email:
______
Child’s Height: ______’ ______Weight: ______/ Other Phone:
______

I hereby authorize my child to participate in the Coconut Grove Sailing Club Sailing Program.

In consideration of the Coconut Grove Sailing Club, Inc. a not-for profit Florida Corporation, providing sailing instruction to my child, I hereby release, acquit, and discharge the Coconut Grove Sailing Club, Inc. its successors and assigns, its employees, agents, members, volunteers, officers and directors from all claims, demands, actions, causes of action, damages, injuries and cost of any nature or kind whether property, personal injury or bodily injury or any other type of injury or damage that may arise from my child’s participation in the sailing program as well as use of the facilities of the Club, and its equipment. This release is on my behalf as the parent or legal guardian and on behalf of my child and any person claiming through my child.

I understand the risks inherent in the sport of sailing and in water sports in general, and in any activity involving children. I attest that my participating child has had swimming instructions and is capable of treading water for five minutes, swimming 25 meters with good form and easy breathing (any stroke) and demonstrates the capacity to alternate floating and treading water for an unlimited period of time. I understand that these skills may help reduce the risks but cannot eliminate them.

I also attest that my participating child is free and unencumbered from any physical or mental impairment and is free of any contagious or infectious disease that might interfere with his or her health or safety during this program.

I hereby grant Coconut Grove Sailing Club and its related companies the right to take, copyright, use, publish, alter, and distribute photographs, movies, films, videotapes, audiotapes, and any other recording of the child. I further irrevocably consent to the worldwide use of the child’s name, voice likeness. I understand that such use may include publicity, advertising, promotion, or any other lawful purpose, without restrictions or remunerations.

I give authorization to the CGSC for treatment in the event of any accident or injury if I cannot be reached. I have read and attest that the above is true and correct.

Parent/Guardian Name: ______Email: ______

Signature: ______Date: ______Phone: (______) ______-______

Medical Information

Allergies/Medication: ______

Emergency Contact: / Authorized Pick Up
I give permission for my child to be released from the Coconut Grove Sailing Club program to the people listed below at any time
Name: ______/ Phone:
(______) ______/ Name:
______/ Phone:
(______) ______
Name: ______/ Phone:
(______) ______/ Name:
______/ Phone:
(______) ______

Sailor’s Name: ______

Club Boat User Agreement

The Club allows the children participating in the competitive racing programs to use the club boats. Each child will be assigned a boat with all working parts. It will be the child and parents’ responsibility to maintain and report any damages. The club will help with the up keep of these boats, unless the child deliberately causes damage or neglects the proper up keep for each boat. We appreciate your cooperation in maintaining these boats, so that we can continue to provide a first class fleet for our future sailors.

Opti parents are expected to maintain the sail-ties and lines as well as provide a mast-clamp for each boat used.

The club provides basic issue sailing equipment. Parents are welcomed to buy higher-end equipment, such as sails, at their own expense to use in combination with the club’s boats.

Respectfully,

Nick Mansbach, CGSC-Sailing Director Geoff Sutcliffe, CGSC-Rear Commodore

Each child will be assigned a numbered Hull, Dagger Board, Rudder, and Sail.

It will be the parent/child’s responsibility to maintain and repair and damages that occur while using the club boats.

The parent and child agree to replace the broken or damaged parts in a timely manner.

The child may not use another club boat while theirs is being repaired.

By signing below, I agree to the terms above.

Child Name: ______Signature: ______

Parent Name: ______Signature: ______

Date: ______

DO NOT WRITE BELOW THIS LINE

TO BE COMPLETED BY OFFICE

Opti / Laser
Hull #:
______ / Rudder:
______ / Hull #:
______ / Rudder:
______
Dagger Board:
______ / Sail:
______ / Dagger Board:
______ / Sail:
______

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