Neryc Form

PARTICIPANT & SESSION DETAILS

PARTICIPANT NAME 1: AGE: LEVEL: ADD CAMP SHIRT $10:

SESSION: SESSION: SESSION: SESSION:

PARTICIPANT NAME 2: AGE: LEVEL: ADD CAMP SHIRT $10:

SESSION: SESSION: SESSION: SESSION:

PARTICIPANT NAME 3: AGE: LEVEL: ADD CAMP SHIRT $10:

SESSION: SESSION: SESSION: SESSION:

PARTICIPANT NAME 4: AGE:   LEVEL: ADD CAMP SHIRT $10:

SESSION: SESSION: SESSION: SESSION:

Notes:
   1. Enter details for each child you are registering. If you wish to register a child in more more than 4 sessions, please include this in the
       ADDITIONAL COMMENTS section below.
   2. All first time participants - Beginner Level - should register for 2 consecutive sessions in order to successfully complete the fundamentals.
       Intermediate and advanced level have the option to register each child for one or more sessions.

EXPERIENCE: HAS ANY PARTICIPANT LISTED ABOVE ATTENDED PREVIOUSLY OR SAILED BEFORE? PLEASE GIVE DETAILS:

ADDITIONAL COMMENTS:

PARENT/GUARDIAN DETAILS

PARENT/GUARDIAN NAME (FIRST): (LAST):

ADDRESS: CITY: STATE: ZIP:

CELL PHONE: PARENT EMAIL:
Please double check correctness

MEMBERSHIP DETAILS:

If you selected your parents as the member please provide their name

PLEASE TELL US WHERE OR HOW YOU FOUND OUT ABOUT THE PROGRAM

Please name the friend, publication or source referenced whenever possible

TERMS & CONDITIONS

THIS REQUEST WILL HOLD THE SESSION SPACE FOR TWO WEEKS ONLY, THEREAFTER THE SPACE WILL BE FILLED ON A FIRST COME FIRST SERVE BASIS. FULL PAYMENT IS REQUIRED SECURE YOUR REGISTRATION. NERYC FULL MEMBER RATES: $125 PER CHILD PER SESSION ADVANCED RACING SPECIALITY SESSIONS - $150 PER SESSION CAMPERS USING THEIR OWN BOAT - RECEIVE $15 PER CHILD PER SESSION DISCOUNT NOTE: MEMBER DISCOUNT IS EXTENDED TO FULL MEMBER CHILDREN AND GRANDCHILDREN ONLY NON-MEMBER RATES: 1 SESSION - $180 PER CHILD 2 SESSIONS - $170 PER CHILD PER SESSION 3 SESSIONS - $160 PER CHILD PER SESSION 4 SESSIONS - $150 PER CHILD PER SESSION 5 OR MORE SESSIONS - $140 PER CHILD PER SESSION ADVANCED RACING SPECIALITY SESSIONS WITH TRAVEL TEAM & CLUB REGATTA OPTIONS - BY APPLICATION ONLY (EVALUATION, INSTRUCTOR RECOMMENDATION & PROGRAM DIRECTOR’S APPROVAL REQUIRED) - $150 PER SEASON PROGRAM FEE PLUS PER SESSION FEES AS PER NON- MEMBER RATES LISTED ABOVE CAMPERS USING THEIR OWN (APPROVED) BOAT RECEIVE $15 DISCOUNT PER CHILD PER SESSION PROGRAM T-SHIRTS - $10 EACH CANCELLATION POLICY: WITHIN 2 WEEKS OF JUNE 18TH - A 50% REFUND. WITHIN 2 WEEKS OF YOUR SESSION - ALL FEES FORFEITED Note: If circumstances create a situation beyond your control, provided we have openings, we will work with you to re-schedule your session within the season. AGE LIMIT: CO-ED 7 -18 YEARS OLD AT START OF SESSION. THE PARTICIPATING GUEST FAMILY ARE GRANTED A TRIAL MEMBERSHIP FOR THE DURATION OF SESSIONS ATTENDED AND THUS SHALL HAVE USE OF THE FACILITIES AND BE REQUIRED TO ABIDE BY CLUB RULES AND CODE OF CONDUCT. PARTICIPANTS ARE REQUIRED TO PROVIDE THEIR OWN LUNCH. SWIM TEST: ALL STUDENTS WILL BE REQUIRED TO SWIM A DISTANCE OF 50 YARDS AND BE ABLE TO DEMONSTRATE THE ABILITY TO TREAD WATER FOR 2 MINUTES, WHILE WEARING A USCG APPROVED LIFE PRESERVER. ALL REQUIRED FORMS (SEE PROGRAM PACKET) MUST BE COMPLETED AND SUBMITTED PRIOR TO PARTICIPATION.

I HAVE READ AND AGREED TO THE TERMS LISTED ABOVE: Yes(Required)

MEDIA PUBLICATION WAIVER

I consent to photographs and /or video that may include images of participants registered above, to be displayed on the website or used in program promotional material (names will not be utilized): Yes No (Required)

SPAM CONTROL

Please type the word above exactly as it appears: (Required)

(Click to send your request)

NOTE:
Once you click SUBMIT, a 'Form Confirmation' page will follow, This will reflect the registration data you have provided.
Receipt of your registration will then be confirmed by the Program Director via email within 72 hours.
Please contact the club (Ph: 410 287 6333) if you do not receive an email conformation within this time.

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