Herreshoff Seamanship Program 2015 Youth Registration
STUDENT INFORMATION
Name: Gender: Date of Birth:
Age: _____
Home Address:
______
City: State: Zip Code:
Home Phone: Email:
Name of Parent/Guardian 1: ______Cell Phone(s):
Name of Parent/Guardian 2: ______Cell Phone(s):
Emergency Contact (other than parents/guardians): ______Cell
Phone(s):______
Physician Name: Phone:
Does student have allergies to food, medication, other? Does he/she carry an EPI pen? If so, please list:
______
______
Please include a copy of your child’s current immunization and physical examination report with the registration form. (Doctors may email this to [email protected] or fax it to (401) 253-6222.)
Does student take daily medication? If so, please list medication(s) and condition(s) being treated:
Are there any additional notes/concerns to be aware of (ie friend requests, missed days, physical limitations, learning disabilities)?
______
______
______
How did you hear about our programs? Print Ad Online Ad Word of Mouth Previous Camper Other ______Pickup Information: Please indicate the individuals authorized to pick up your child from Herreshoff Programs that are not a parent or guardian. They will be required to sign your child out when they arrive at Building 17.
1. ______Name Relationship Phone # 2. ______Name Relationship Phone # 3. ______Name Relationship Phone #
Please contact the Sailing School Director, Maria Coughlin, with further questions and concerns at 401-396-5834 or [email protected] 2015 HERRESHOFF SEAMANSHIP PROGRAM
Class sizes are limited and will be filled on a first come, first serve basis. Early registration is recommended as 2014 sessions were sold out. Registration forms and a 50% deposit are required to reserve your spot in any class. A waiting list will be created once space in classes is full and you will be notified as soon as space opens up.
YOUTH SAILING SESSIONS
With a one week session, students learn the basics – boat terminology, wind direction, tacking & jibing. We highly recommend that students join us for additional weeks to get the best experience. Students who sign up for additional weeks will have the opportunity to achieve their “Guppie” (ages 7-9) or “Mate” certification (ages 10+) and build on their skills. As students’ progress with each week, they will have the opportunity for independent sailing and more advanced seamanship topics to advance towards their “Bosun” certification. Students will be grouped by age, ability and number of sessions attended. Please be aware that in the case of heavy winds or rain, we will hold class indoors with age appropriate activities.
Please Circle One or More: Session 1 – June 22 – June 26 Session 2 – June 29 – July 3
Session 3 - July 6 – July 10
Session 4 – July 13 – July 17
Session 5 – July 20 – July 24
Session 6 – July 27 – July 31
Session 7 – August 3 – August 7
Session 8 – August 10 – August 14
Session 9 – August 17 – August 21
SCHEDULE & FEES
All classes are Monday – Friday. Full Day class is 8:45am – 3:30pm. Half Day class is 8:45am-12:00pm. Advanced Teen is 12:30-3:30pm. Parents are invited to sail with their children each Friday from 12:30-3:30 with advance sign-up. This is included in tuition for full day class (additional fee applies for morning class). Scholarships are available to those who qualify.
Morning ½ Day Class
Session # _____ x $_____, Session # ______x $_____, Session # ______x $______$______
Family Sail Fridays: Additional $25 to stay for the afternoon $______
Half Day is priced at $170 (first week), $160 (second week), $150 (all additional weeks)
Full Day Class Session # _____ x $_____, Session # ______x $_____, Session # ______x $______$______Full Day class is priced at $300 (first week), $275 (second week), $260 (all additional weeks) Advanced Teen Class Session # _____ x $_____, Session # ______x $_____, Session # ______x $______$______Half Day is priced at $170 (first week), $160 (second week), $150 (all additional weeks) Instructor-in-Training (please contact Maria to apply) First Year (6 weeks): $810 (50% of normal tuition) Second Year (9 weeks): No tuition and compensated at non-profit minimum wage $______*Siblings receive a 5% discount for each week attended. TOTAL DUE: $ 50% due with registration: $
Balance due 30 days before first day of class: $
Full payment is required no later than 30 days before the first day of class. Refunds will be issued to withdrawals received 4 weeks before class. Cancellations made 15 to 29 days prior to the start of a class will receive a refund less an administrative fee of 50% of the course cost. No refund will be given if cancelled within 14 days of the course. Please make check payable to Herreshoff Marine Museum or fill in credit card information below and mail completed form to Herreshoff Marine Museum, PO Box 450, Bristol, RI 02809.
Card Number: Expiration: CVV:
Billing Address: ______
Zip Code: ______Amount to be charged: ______Signature:______
RULES, REGULATIONS, TERMS OF SERVICE, WAIVERS OF LIABILITY, AND MEDIA RELEASE
I, (student, or parent/guardian if under 18), wish to have participate in the Herreshoff Marine Museum Seamanship Program. I understand and consent to the following: 1. Reasonable accommodation will be made to include all sailors in a class that matches their interests and abilities. 2. A swim check or proof of ability to swim is a pre-requisite for enrollment, and I give permission for supervised swimming. Students must swim 50 yards wearing a life jacket and tread water for 2 minutes 3. Students shall provide their own USCG approved life jackets, which will be worn whenever the student is in a boat or on the docks. 4. I accept the above payment terms (or as amended through the award of a scholarship) and agree to make payments accordingly. 5. MEDIA RELEASE. I consent to my child being photographed, interviewed and/or videotaped by representatives of HMM and media outlets (newspaper, T.V. & radio stations, etc.). Any information or images obtained from those activities may be reproduced by HMM, its sponsors, and/or the public media for use in advertising, publicity or educational activities, including but not limited to web sites, publications, videos, print and television news. I hereby waive any claims I may have, and release HMM and its representatives from liability of claims arising out of such activities. 6. MEDICAL WAIVER, RELEASE AND INDEMNITY. I authorize HMM, and its officers, directors, employees and volunteers to obtain or provide emergency medical treatment for the above named student if I cannot be contacted at the time of an emergency. I hereby release HMM, its officers, directors, employees, agents and volunteers, from any and all claims, demands, actions or causes of action which I, my heirs, personal representatives or assigns have or may have arising out of obtaining or attempting to obtain each service, care and/or treatment. Further, I hereby promise and agree and covenant to totally and completely defend, indemnify and hold harmless the above entity and persons from any and all claims, demands, actions, or causes of action by any person arising out of obtaining or attempting to obtain each such service, care or treatment including but not limited to direct actions, third party actions, claims, cross claims, demands or actions for contribution and/or indemnification 7. GENERAL RELEASE AND INDEMNITY. I understand that the ultimate decision as to whether my child’s swimming ability is sufficient for my child to safely participate in the HMM programs and activities is mine. I have determined that my child is capable of participating in the HMM programs and activities. In making this determination I acknowledge that there are inherent risks in sailing and other water-based and land-based activities and that accidents can occur on the water as well as on land during any HMM program. Such accidents can result in serious personal injury including death and property damage. Therefore in consideration of my child’s participation in the HMM program, I do for my child, myself, personal representatives, next of kin and assigns, knowingly and freely release and discharge the Herreshoff Marine Museum, its officers, directors, members, affiliates, employees, volunteers and helpers from any and all liability for any claim, including claims for personal injuries, loss of property, damage and expense, which may result from my child’s participation in HMM programs even though such personal injuries or loss of property may arise out of negligence or carelessness on the part of the entity or persons mentioned above. In addition, I do for my child, myself, personal representatives, next of kin and assigns, knowingly and freely agree and covenant to totally and completely defend, indemnify and hold harmless the above described entity and persons from any and all claims, demands, actions, causes of action by any person with respect to personal injuries, loss of property, damage and expense from my child’s participation even though such personal injuries or loss of property, damage and expense may arise out of negligence or carelessness on the part of the entity or persons mentioned above.
Signature (Student, or parent/guardian if under 18) Date
PROGRAM RULES
For the safety and well-being of all students, parents & students must review our rules before attending the sailing school. All students and parents must sign below ensuring that they understand and will adhere to the rules of our program. Calls home will be made if students are breaking the rules, and repeat offenders will be asked to leave the program if the Sailing Director believes he/she is putting the program and other students at risk.
1. Respect – all students will respect the boats, the classroom building, instructors, peers, and the Museum.
2. Buddy System – all students will have a buddy when visiting the restroom in the museum or crossing the street
3. PFDs and shoes must be worn (zipped & buckled) at all times on docks and on the boats
4. No pushing, biting or fighting will be tolerated.
5. No foul language or name calling will be tolerated.
6. Instructors have the final say both on land and on the boats – please respect their decisions.
7. No crossing the street without an instructor.
8. Parents must call or email the Sailing Director when students will be absent or late.
9. Students will help keep the classroom building clean & organized by keeping their PFDs hung up, throwing away trash, and keeping personal items in cubbies.
10. Please stay hydrated & protected from the sun (water bottle, hats, sunscreen, shirts) to prevent heat exhaustion.
11. The Herreshoff Marine Museum may revoke all sailing privileges for violation of any rules or regulations.
______Parent/Guardian Student Please contact the Sailing School Director, Maria Coughlin, with further questions and concerns at 401-396-5834 or [email protected]