Don T Know How to Sail, No Worries, We Will Teach You!

don’t know how to sail,no worries, we will teach you!

Don’t have a boat? nO worries, club boats will be available for use!

Don’t want to do it alone? No worries, bring a friend. Adult lessons are open to anyone (members or Non-Members!

Don’t want to sit on the beach during the regatta? No worries, you will be saling by July 16th and ready to race!

We will be offering adult sailing lessons taught by our very own instructors on Wednesdays throughout the summer beginning on June 29th. They will teach you all aspects of sailing and racing. All ability levels are welcome. The cost is $75 for the summer. Please email to reserve your Spot.

Still Saying you can’t sail…you definitely can!!

WEQUAQUET LAKEYACHT CLUB

Adult Sailing Lessons

I hereby apply for acceptance in the Wequaquet Lake Yacht Club Sailing Program and agree that I will abide by the By-Laws and Rules of the Sailing Program and Wequaquet Lake Yacht Club.

The cost for the program is $75 for the summer.

Participant: ______Phone: ______

Address: ______

Email: ______(for notification of upcoming sailing info)

EMERGENCY INFORMATION

Please indicate a relative or friend that can authorize and consent to necessary emergency medical treatment:

Name Relationship Phone

1.) ______

2.)______

MEDICAL INFORMATION

Doctor/Clinic:______Phone:______

Insurance # ______

Please check those that apply: (Provide necessary details below)

CHRONIC AILMENTS: / ALLERGIES:
ASTHMA OR OTHER RESPIRATORY PROBLEMS / MEDICATION
DIABETES OR HYPOGLYCEMIA / LATEX
HEMOPHILIA, OR OTHER BLEEDING PROBLEMS / BEE STINGS/INSECT BITES
CIRCULATORY OR HEART PROBLEMS / IF YES, DO YOU CARRY AN EPIPEN?
EPILEPSY/SEIZURE / FOODS
OTHER / OTHERS, IF SIGNIFICANT

DATE OF LAST Tdap (Tetanus/Diphtheria/Acellular Pertussis) SHOT: ______

CURRENT MEDICATIONS:______

WLYC AUTHORIZATION FOR TREATMENT

In the event I,______, is injured or

ill while participating in the Wequaquet Lake Programs, I hereby give my permission for the administration of all reasonable health care treatment. I

expressly authorize any coach, officer, member or volunteer from WLYC

to consent to such health care treatment. Such treatment may include but is not limited to x-ray examination, dental, anesthesia, medical or surgical diagnosis or treatment or hospital care. It is given to provide the authority and power to the health care professionals to exercise their best

professional judgment. It is understood that efforts will be made to

contact me prior to providing such treatment but I also understand that the treatment may occur if I cannot be contacted. I also agree to pay

reasonable cost of any such health care attention or treatment and to reimburse the Wequaquet Lake, or any person who incurs expenses for this health care treatment.

Signature:______Date:______