Join YOUR High School Team!
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2021 HIGH SCHOOL SAILING PROGRAM EMERGENCY MEDICAL AUTHORIZATION FORM Sailor: ________________________________________ Team/School: ___________________________ Sailing Parent: _______________________________________ Cell#: _________________________________ EXTREME RACING SERIES Male Female Age: _______________________ DOB: __________________________________ Home Address: _________________________________________________________________________ This form enables parents/guardians to authorize emergency treatment for children who become ill or injured while participating in the High School Sailing Program while at Hoover Sailing Club In the event of an emergency involving a participant all reasonable attempts will be made to contact the parents or guardians listed below. Emergency medical personnel will be notified for transfer to the nearest hospital if necessary. Parent or Guardian Name Relationship Cell Phone Parent or Guardian Name Relationship Cell Phone Parent or Guardian Name Relationship Cell Phone MEDICAL INFORMATION Child’s Physician Phone Allergies Join YOUR High School Team! Current Medications OPEN TO GRADES 7–12 Ongoing Medical Conditions or Physical Impairments Date of last Tetanus shot WHAT ARE THE BENEFITS OF SAILING AS A HIGH SCHOOL SPORT. JOINING THE SAILING TEAM? Competitive sailing involves fast-paced, short-course MEDICAL INSURANCE INFORMATION (optional – this may assist staff in the event that your child is taken to the team racing, where one-design boats race each other hospital for treatment) • Sailing is a true co-educational competitive sport. without any handicaps, starting at the same time, sailing • Colleges actively recruit talented sailors for their college a set course and the winner of each race is the first to Insurance Carrier Insurance Phone teams. cross the finish line scoring points based on finish position • Sailing not only involves a high level of physical strength with the lowest points winning. Teams compete locally, Group Policy # Plan # and agility but it teaches students about navigation, regionally and nationally in regattas and championships. PLEASE COMPLETE EITHER PART I or PART II of this form. physics, the marine environment, and the importance of teamwork. PART I - CONSENT I do hereby give my consent for emergency medical treatment of my child in the event of accident, illness, or • Sailing is an activity that literally can take you around injury. the globe and provide a warm introduction to other sailors in just about any country. Parent or Guardian Name Date • Sailing is a sport that you will enjoy throughout your life. PART II - REFUSAL TO CONSENT (Do not complete if you completed Part I) • Supervised use of host club facilities, offering quality I do not give my consent for medical treatment of my child and agree to be on-site at all times in a pre- access to the water. determined location. In the event of illness or injury requiring emergency treatment, I wish the instructor to take • Safety and rescue boats are on the water at all times no action and agree to act in accordance with the parent’s/guardian’s wishes as I understand them. with liability coverage under the Club’s insurance policy. Parent or Guardian Name Date • Professional coaching during regattas and practices. 2021 HIGH SCHOOL SAILING PROGRAM 2021 HIGH SCHOOL SAILING PROGRAM HOOVER SAILING CLUB WAIVER & RELEASE www.hooversailingclub.com Please Print and Turn in at Registration. One per Sailor. For more information contact Head Coach Jamie Jones at Sailor DOB [email protected] 614-216-2679 School Join us! Hoover Sailing Club (HSC) grants conditional use of Club water access and vessel use to SPRING OPEN HOUSE WELCOME ABOARD! registrants of the Hoover Sailing Club High School Sailing Program for the Sailing Season, 2018. Sunday, March 28 at 6:00 PM High school sailing is the fastest going sport in the US including Ohio. The sport of sailing The undersigned and Sailor agree to: FALL OPEN HOUSE typically operates with the permission of your high school using Hoover Sailing Club 1. Be bound by Hoover Sailing Club rules. Saturday, August 21 at 6:00 PM (HSC) fascilities, gear and coaches. It is a pay-to-play sport. 2. Waive any and all liability and release of any claim, including those for negligence, the We practice three times a week on Monday, Tuesday and Thursday with a start time on undersigned may now have or may hereafter acquire against Hoover Sailing Club and its PRACTICE: the water at 5:00 PM. This means come early to help rig boats. Practice is over by 7:30 PM directors, officers, employees, agents, members and associate volunteer personnel arising Monday, Tuesday and Thursday (earlier as the sun sets earlier). Regattas fall on the weekends locally and regionally. out of or relating to my use of the Hoover Sailing Club facilities and vessels. 5:00–7:30 PM 3. Assume full responsibility for the risks of participation in boating and damage to property or Coaches may add practice dates. PLEASE PRINT CLEARLY. ONE APPLICATION PER STUDENT: persons. Spring Season: 4. Be fully responsible for any injury to person or property, including but not limited to motor March 29–May 13 vehicles and/or vessels, the undersigned or Sailor causes on Club Property. Neither the Club Student’s Name $200 nor its personnel shall be liable for any injury to person or property resulting from the use of Fall Season: Hoover Sailing Club facilities by the undersigned or Sailor while on Club grounds or nearby Parent’s name August 24–October 28 waters. $250 In addition, the undersigned agrees that Hoover Sailing Club, and all of its respective members, Address officers, directors, employees, agents, volunteers, as well as all persons acting in a volunteer SUMMER CLINICS: capacity regarding the conduct of the Events (“Released Party” or collectively “the Released Monday through Friday City/State/Zip Parties”), shall not be responsible or liable for the personal injury, death, and/or property loss 8:30 AM–4:00 PM or damage suffered by the Sailor or any third party arising out of or related to the Sailor´s These classes are geared toward Email address (please print clearly) participation in the Events whether or not any such liability is caused in whole or part by the the newer sailor as an immersion negligence of a Released Party. By consenting to the participation of the Sailor in the Events, the undersigned, himself/herself and on behalf of the Sailor and their respective heirs, successors, into the sport of team sailing. In Phone: home cell Alternate Phone: home cell these courses, we’ll cover the and assigns, hereby waives all claims against the Released Parties for, and releases the Released basics of sailing and racing. We’ll Parties from, any and all liability, including personal injury, death and property damage claims focus on boat-handling, racing Birthdate Height Weight arising out of the Sailor´s participation in the Events, whether or not any such liability is caused rules, sail trim and boat placement in whole or part by the negligence of a Released Party, to the fullest extent permitted by law. as well as short course race tactics. High School Sailor will Attend Graduation Year However, the undersigned Parent and Sailor do retain any and all rights against any other Summer Clinic:July party for damages of any nature resulting from any intentional acts and/or wrongful acts not 6–9 School Attending Now directly related to the Sailor’s participation in the daily activities of the Events, including all times $200 before the start and after the activities of the Events for that day. Parties hereto understand that in accordance with Rule 82 of the Racing Rules of Sailing and the Bylaws of US Sailing, no Pre-Season Clinic: HELP US GET TO YOU KNOW YOUR SAILOR: indemnity clauses shall be required by any party. August 2–6 SAILING EXPERIENCE: classes taken, classes of boats sailed, racing or crew experience, $200 knowledge of rules, etc. The undersigned gives permission for photographs and videos of the Sailor to be used at the sole discretion of HSC, the Released Parties and the Organizing Authority, at which the photo TOTAL: _________________ was taken. Please make checks payable to: MEDICAL CONDITIONS: list any conditions or allergies (e.g., allergy to bee sting, severe asthma, behavior issues, etc). Signed (Sailor) Date HOOVER SAILING CLUB Mail application and fee to: Signed (Parent/Guardian) Date HOOVER SAILING INSTRUCTION SWIMMING ABILITY: include formal classes and highest level achieved. c/o Jamie Jones Parent/Guardian Name Printed 581 Braxton Place East Westerville, OH 43081 Mailing Address 2021 HIGH SCHOOL SAILING PROGRAM 2021 HIGH SCHOOL SAILING PROGRAM HOOVER SAILING CLUB WAIVER & RELEASE www.hooversailingclub.com Please Print and Turn in at Registration. One per Sailor. For more information contact Head Coach Jamie Jones at Sailor DOB [email protected] 614-216-2679 School Join us! Hoover Sailing Club (HSC) grants conditional use of Club water access and vessel use to registrants of the Hoover Sailing Club High School Sailing Program for the Sailing Season, 2018. SPRING OPEN HOUSE WELCOME ABOARD! Sunday, March 28 at 6:00 PM High school sailing is the fastest going sport in the US including Ohio. The sport of sailing The undersigned and Sailor agree to: FALL OPEN HOUSE typically operates with the permission of your high school using Hoover Sailing Club 1. Be bound by Hoover Sailing Club rules. Saturday, August 21 at 6:00 PM (HSC) fascilities, gear and coaches. It is a pay-to-play sport. 2. Waive any and all liability and release of any claim, including those for negligence, the We practice three times a week on Monday, Tuesday and Thursday with a start time on undersigned may now have or may hereafter acquire against Hoover Sailing Club and its PRACTICE: the water at 5:00 PM. This means come early to help rig boats.