Subject

Adaptive SailingAdult SailingCommunity OutreachYouth SailingFamily/First Sail/Make your own SailKeelboat, Basic or Instructor'sPrivate InstructionRacing, Cape Cod KnockaboutsRent-a-Sailboat

Date of Sail:

Participant name

Date of Birth:

Your email

Phone:
Address:

Emergency Contact:
Contact Phone #:

List any Medical Conditions staff should be aware of (e.g. food/drug/bee sting allergies, medication, etc.)
Medical Conditions: (optional)

Authorization:
I/We, the undersigned applicant and/or parent(s) or guardian(s) of the minor participants listed on this form, do hereby consent to my child’s participation in the boating programs of Sail Cape Cod. I/We, do hereby, for ourselves, our heirs, spouses, family members, personal representatives and assigns, agree to indemnify and hold harmless Sail Cape Cod, its officers, board members, employees, members, volunteers, and any individuals and organizations assisting or participating in its programs, against any and all suits, actions, claims, costs or demands, whether arising from sole or concurrent negligence or otherwise including those, resulting from death, personal injury, and property damage, to which Sail Cape Cod, its officers, board members, employees, members, volunteers, and any individuals and organizations assisting or participating in its programs may be subject by reason of the students listed on this form participating in the programs of Sail Cape Cod and/or their presence on board any of its boats, floats, facilities, or any other places in connection with Sail Cape Cod. I/We understand that boating is a hazardous sport. I/We also understand that to minimize the hazard as much as possible the student(s), if permitted to participate in the instructional program, will be subject to the rules of Sail Cape Cod and the control of the instructional staff – both employees and volunteers. I/We hereby authorize any of the members, officers, board members, employees, or volunteers of Sail Cape Cod to give permission to any physician, hospital, or other medical practitioner or facility for any medical, surgical, dental, or other treatment that may be necessary or desirable for the participant’s well-being in the event of illness or bodily injury. If major emergency, surgical treatment is immediately required, I/we request that reasonable efforts be made to reach me for consultation, but understand that such consultation is
not a prerequisite for such treatment.
By signing below, I/we, the undersigned applicant and/or parent(s) or guardian(s) of the minor participant named above, hereby acknowledge that I/my child may be photographed while participating in Sail Cape Cod activities. I/We hereby unconditionally authorize Sail Cape Cod at its sole discretion to use any such photographs in fundraising, advertising, brochures, website promotion, promotional flyers and any other public relations and advertising medium.

Please type your name as a signature:

This form uses Akismet to reduce spam. Learn how your data is processed.