PO Box 254 Rockport, ME 04856 www.rockportboatclub.org APPLICATION Thank you for your interest in the Summer Sailing program at the Rockport Boat Club. Whether you are a returning student, or someone looking forward to joining us, we welcome you! Take some time to read the course descriptions on our website and then complete the application below. We look forward to seeing you this summer. Please complete one application per student. Please include your email address for up to date class announcements. Applicant s Last Name: First Name: Age as of July 1: DOB: Height: Weight: *To enroll in beginner s level, student must be entering 3 rd grade in the fall through 12 years old. Parent/Guardian s Name: Home Tel: e-mail address: Cell Phone: SUMMER Mail Addr: Town: ST: Zip: WINTER Mail Addr: Town: ST: Zip: Students will receive a t-shirt; please indicate your size: (better too big...) (Youth M) (Youth L) (Adult S) (Adult M) (Adult L) Previous Sailing Experience: Previous Swimming Experience: Please complete the next page to indicate your class selections, and mail this application to: RBC Sailing Program PO Box 254, Rockport ME 04856 Full payment must be made with your application. Please make checks payable to Rockport Boat Club. To complete your application please print and include with your application and payment the Medical History form and the Statement of Understanding and Signature form. Questions? For more information about our programs or other program questions, contact Youth Sailing Director at youthsail@rockportboatclub.org. For information on club membership please visit our website at www.rockportboatclub.org.
MEDICAL HISTORY FORM STUDENT NAME: DOB: PARENT/GUARDIAN'S NAME: TEL: CELL/OFFICE : EMERGENCY CONTACT: (Please provide the names and telephone numbers of people (at least one out of family) that will be accessible during sailing class hours. These forms are kept at the boat house for use by the instructors as needed, (Name) (Name) (Address) (Tel) (Cell) (Address) (Tel) (Cell) SPECIAL MEDICAL NEEDS, ALLERGIES, ETC.: PLEASE PROVIDE US INFORMATION ABOUT ANY PHYSICAL LIMITATIONS, FEARS OR OTHER BEHAVIORAL OR SOCIAL ISSUES/CONCERNS WE SHOULD BE AWARE OF: CURRENT MEDICATIONS: DO ANY OF THESE NEEDTO BE DISPENSED DURING CLASS? (y) (n) What? If so, please speak to your child s instructor to make arrangements. DATE OF LAST TETANUS SHOT: Month: Year: PHYSICIAN: PHONE: HEALTH INSURANCE CARRIER: POLICY # GROUP # Tel #: POLICY HOLDER S NAME: PARENT/GUARDIAN EMERGENCY MEDICAL TREATMENT AUTHORIZATION I, (Parent/Guardian) authorize the Rockport Boat Club program organizers and/or employees to sanction emergency medical treatment for my child (Name ) if you or your emergency contacts cannot be reached at the time of an emergency. SIGNATURE DATE
www.rockportboatclub.org youthsail@rockportboatclub.org SUMMER SAILING PROGRAM STATEMENT OF UNDERSTANDING AND SIGNATURE PAGE By enrolling my child(ren),, in the sailing program at the Rockport Boat Club, I understand that my child is embarking on a fun and challenging experience. I further acknowledge that because safety is such an integral part of any sport, my child will abide by the Rockport Boat Club Rules as stated by the RBC Sailing Instructors and the policies in the enclosed Parent Information Sheet. Simply stated, I understand that my child must use care with the boats used in the RBC Sailing Program, that he/she will follow the instructions of the RBC Sailing Instructor, and that horseplay and carelessness around the Rockport Boat Club will not be tolerated, as it might put other children and/or equipment in jeopardy. Although sailing is a fun, challenging, and an exciting sport, it is a sport that involves some risk. I agree that my child will wear an approved water safety device (life jacket) at all times while on the water or on the floats. I have discussed any questions I have regarding the RBC Sailing Program and its possible risks with the RBC Youth Sailing Program Director, (youthsail@rockportboatclub.org), and on behalf of my child and myself, I agree to release the Rockport Boat Club, its sailing program and employees from any and all liability resulting from my child's participation in the Program, and to hold them harmless. SIGNATURE OF PARENT/GUARDIAN : DATE: I ALSO AGREE TO RESPECT AND FOLLOW THE TERMS OF THE PARENTS INFORMATION LETTER. SIGNATURE OF PARENT/GUARDIAN DATE SIGNATURE OF STUDENT(S) DATE SPECIAL EVENTS & PUBLICITY PARENTAL PERMISSION STATEMENT I grant permission for to participate in special events and activities as part of the Rockport Boat Club Sailing Program in which he/she is a registered student. I understand that the boats, captains, Rockport Boat Club and its Board of Directors, or the RBC including its instructors, director and volunteers hold no liability for these events. I require that my student wear his life jacket at all times when he/she is in or on the water. I expect to receive a notice of each event prior to its happening within reason. This statement may be withdrawn at any time through a written request to the Program Director delivered to class. I give the RBC and sailing program permission to use photographs and other statements/materials that include my child in publicity materials, website and media articles/announcements. SIGNATURE OF PARENT/GUARDIAN DATE Special Conditions:
www.rockportboatclub.org Welcome to the RBC Summer Sailing Season PARENT INFORMATION SHEET Parents, please read this carefully. It really helps the instructors out a great deal if we all start off knowing the same things. Thank you! Both parent and student must sign the signature space for this document on the Statement of Understanding/ Signature Page, and return it with the Medical History Form and your final balance. This is due upon receipt of this packet. Sailing Program Rules: 1. PFDs must be worn at all times on the docks and while in the boats. 2. Rubber soled footwear must be worn at all times. 3. No running or horseplay allowed on the premises. 4. Please respect your classmates no hitting, bossing, or other disruptive or harmful behavior. We reserve the right to remove a child from class if this occurs. 5. Sailing is a partnership between the skipper and his/her crew. The program is based on camaraderie, respect, fun and fairness. 6. Instructors reserve the right to transfer students to a different level of class (higher or lower) based on their sailing skills and maturity. The program is designed to teach everyone sailing skills at the ability they can actively participate and keep the class united. A discussion will be held between the parent and instructor prior to making such a change. 7. Please respect all the RBC boats, equipment and property. Please store your backpacks and gear on designated hooks provided by the club. 8. Please stay out of the kitchen. 9. Please keep the sails and sail room clean and in order. CLOTHING SUGGESTIONS: 1. Your own life jacket (type III) is essential. We do have a few extras on hand, but please do try to remember yours every day. 2. Sunscreen, sunglasses, and/or a hat are essential. You'll constantly hear us reminding you to put sunscreen on. 3. Rubber soled shoes are essential. Please do not wear your favorite basketball sneakers that cannot get wet. We will not allow you to sail barefoot; it's too dangerous. Tevas (or similar) are acceptable footwear. 4. A sweatshirt or some other sort of additional layer -- it's always chillier out on the water no matter how warm it is on shore. In addition, a wind breaker is always good to have on hand. 5. A complete change of clothes, shoes and a towel is absolutely essential to have with you every day. You never know when you might get splashed, or even dunked, and you cannot stay in your wet clothes all day. NEVER FORGET A CHANGE! Page 1
6. On rainy days we will try to go out, so a rain jacket and rain pants (if you have them) are helpful. 7. All possessions should be kept in a backpack or closed bag. Do not bring valuables to the club. Although theft is very rare here, the RBC is not responsible for the loss of your personal property. Bags are left unattended at the club when sailing or near the water. TIMELINESS: 1. It is very important that everyone get to class on time. Please arrive for class 5-10 minutes prior to starting time. Instructors need the full half hour before morning class starts to prepare for that class, and so we ask that drivers respect this request; we cannot leave students unattended on the waterfront. On the other hand, don't be late -- once we start, it's hard to play catch-up, especially if we're already out on the water. Please pick up your sailors promptly at the end of class; the instructors need to prepare for the next class or tidy up at the end of afternoon, which means we are not around to supervise kids. 2. If your child will not be attending class on a given day, please call the RBC at 236-4900 and leave a message on the machine prior to the start of class. The message machine works well and is checked at the beginning and end of each class and often in-between. CONTACTING YOUR CHILD DURING CLASS (AND VICE VERSA): 1. This may be done only in an EMERGENCY (i.e. family crisis, or the like). Instructors are on the water with classes and not available to get messages about schedules, changes in plans, or anything else that does not require immediate action. Under most circumstances, boats cannot return to the dock to disembark students unless an emergency crisis is in process. 2. In such a crisis, call the harbormaster at 236-0676 and she can radio to a boat. For any reason that you want information to get to your child, call the boat club at 236-4900 and leave a message if no one is there to answer. Messages are always checked at the end of class and the house phone can be used to respond. 3. Students may not take a cell phone on/near the water for safety, protection and reception purposes. They are to be turned off during class hours, unless specifically approved by the instructor. 4. The rules for communication from the boat to land are the same, in reverse to those outlined above. SWIM TEST: 1. Before anyone is allowed to sail, a simple swim test is required. The ocean is cold, and we want everyone to be prepared should they capsize or fall in. It's nothing to worry about, and the instructors usually end up having to drag the sailing students out of the water every day! We will get the swim test done on the first day so we can start sailing; please come prepared on the first day with a complete change of clothes, towel, and a swimsuit, as you should every day. 2. No exceptions without prior consent. The results of this test are part of the confirmation that your student is placed in the proper level of instruction. If there is anything that still seems unclear, please just ask. Everything works best when we have open lines of communication between parents, sailors, and instructors. Remember this is all about fun, making friends and learning the ropes of sailing. Please see the space on the Document of Understanding for both parent and child to sign confirming they have read this agreement and agree to abide by it during their participation in the. Page 2