Junior Sailing Program Registration 1JUNIOR SAILOR INFORMATION2PARENT/GUARDIAN INFORMATION3COMMUNICATION4PROGRAM SELECTION5PROGRAM PRICE AND FEES6HOW TO PAY7AUTHORIZATIONS WELCOME TO 2023 REGISTRATION! Starting January 1, 2023 the PYC will accept registrations for members only. If slots are filled, registrations will be timestamped and sailors will be placed on a waiting list in order as received. Starting February 1, 2023 PYC will open registration to non-members. If slots are filled, registrations will be timestamped and sailors will be placed on a waiting list in order as received. Register by April 30 to take advantage of the early bird fees listed below. Registrations received beginning May 1 will be $20 more per session. Session Availability: The Junior Sailing Program website will list the number of slots available for each program. If a session is full, your sailor will be placed on a waiting list. You will be contacted if a slot opens up. Confirmation: All registrations will receive a confirmation email. If you do not receive a confirmation upon completion and submission of this form, please check your spam folder for these. Deposit: There will be a non-refundable $50 processing fee due at the time of registration for each junior registered. This will be deducted from your final payment. Late Fee: a 5% late fee will be appplied to all outstanding balances effect June 1. Swim Drill: All sailors are required to take a swim drill the first day of each session. The drill includes swimming in a bathing suit and shoes along the length of the junior float (50 ft), treading water for 30 seconds, and putting on a lifejacket in the water. Sailors in the Minnow program will wear life jackets in a modified drill. Sailors can retake the drill if needed and coaches will offer support as needed. Program: All classes operate Monday – Friday from 9:00am-4:00pm Morning half-day classes begin 9:00am-12:00noon Afternoon half-day classes begin 1:00pm-4:00pm Some programs have prerequisites and suggestions included in the class description. https://www.portlandyachtclub.com/junior-sailing If the Program Director feels your sailor would do better in a program other than what you chose he or coach will contact you to discuss. Questions: If you are unsure of the level of sailing for your sailor or have questions about the session content, please contact Junior Program Director Junior.Director@pycme.net For all other questions, please contact Kelley Rich at manager@pycme.net or (207) 781-9820JUNIOR SAILOR INFORMATIONSAILOR REGISTRATION NUMBER If you are registering more than one sailor, check 1 for the first, 2 for the second, etc.Registration Fees Price: $0.00 Sailor Sequence 1 2 3 4 Sailor First Name or Nickname* Sailor Last Name* Sailor Email* Sailor’s Date of Birth* MM slash DD slash YYYY Weight in pounds (approximate)*Please enter a number from 30 to 180.T-SHIRT SIZEEach sailor will receive a PYC Junior Sailor t-shirt. Please select the best fit from the list below.Shirt SizeChoose oneChild SmallChild MediumChild LargeAdult Extra SmallAdult SmallAdult MediumAdult LargeAdult Extra LargeHas your sailor previously participated in PYC Jr Sailing?* Yes No Don’t Know Select the most recent program level of participation Minnows (one week, half day) Beginner (two weeks, half day) Beginner/Novice (two weeks, full day) Intermediate Green Fleet Advanced Race Team Add any comments you may have about PYC ParticipationIn what years did this sailor participate in the PYC Program? 2018 2019 2020 2021 2022 Has this sailor participated in a Junior Sailing Program other than PYC?* Yes No Please provide details — e.g., program name, sailing level (beginner, intermediate, advanced), type(s) of boats sailed.Does this sailor have any boating experience other than Junior sailing?* Yes No Please provide details — type(s) of boat(s), degree of involvement (passenger, Some crew work, steering, etc.)Does this sailor take any prescription medications?* Yes No list name, frequency, and dosage of each medication*Does this sailor have any allergies to medications or food?* Yes No Please list by type and symptoms that could indicate an allergic Episode*Are there any conditions that could limit this sailor’s ability to participate in the full range of program activities?* Yes No If you answer Yes, please contact the Junior Program Director, at junior.director@pycme.net for a confidential discussion of the condition and what accommodations might be made to enable your sailor to participate. The Portland Yacht Club Junior Sailing Program will make every effort to make accommodation. However, the Club may deny participation if in its sole judgment the Club believes the risk of injury to the child is high even with an accommodation.Sailor 2 InformationSailor First Name or Nickname Sailor Last Name Sailor Email Sailor’s Date of Birth MM slash DD slash YYYY Weight in pounds (approximate)Please enter a number from 30 to 180.T-SHIRT SIZEEach sailor will receive a PYC Junior Sailor t-shirt. Please select the best fit from the list below.Shirt SizeChoose oneChild SmallChild MediumChild LargeAdult Extra SmallAdult SmallAdult MediumAdult LargeAdult Extra LargeHas your sailor previously participated in PYC Jr Sailing?* Yes No Don’t Know Select the most recent program level of participation Minnows (one week, half day) Beginner (two weeks, half day) Beginner/Novice (two weeks, full day) Intermediate Green Fleet Advanced Race Team Add any comments you may have about PYC ParticipationIn what years did this sailor participate in the PYC Program? 2018 2019 2020 2021 2022 Has this sailor participated in a Junior Sailing Program other than PYC?* Yes No Please provide details — e.g., program name, sailing level (beginner, intermediate, advanced), type(s) of boats sailed.Does this sailor have any boating experience other than Junior sailing?* Yes No Please provide details — type(s) of boat(s), degree of involvement (passenger, Some crew work, steering, etc.)Does this sailor take any prescription medications?* Yes No list name, frequency, and dosage of each medication*Does this sailor have any allergies to medications or food?* Yes No Please list by type and symptoms that could indicate an allergic Episode*Are there any conditions that could limit this sailor’s ability to participate in the full range of program activities?* Yes No If you answer Yes, please contact the Junior Program Director, at junior.director@pycme.net for a confidential discussion of the condition and what accommodations might be made to enable your sailor to participate. The Portland Yacht Club Junior Sailing Program will make every effort to make accommodation. However, the Club may deny participation if in its sole judgment the Club believes the risk of injury to the child is high even with an accommodation.Sailor 3 InformationSailor First Name or Nickname Sailor Last Name Sailor Email Sailor’s Date of Birth MM slash DD slash YYYY Weight in pounds (approximate)Please enter a number from 30 to 180.T-SHIRT SIZEEach sailor will receive a PYC Junior Sailor t-shirt. Please select the best fit from the list below.Shirt SizeChoose oneChild SmallChild MediumChild LargeAdult Extra SmallAdult SmallAdult MediumAdult LargeAdult Extra LargeHas your sailor previously participated in PYC Jr Sailing?* Yes No Don’t Know Select the most recent program level of participation Minnows (one week, half day) Beginner (two weeks, half day) Beginner/Novice (two weeks, full day) Intermediate Green Fleet Advanced Race Team Add any comments you may have about PYC ParticipationIn what years did this sailor participate in the PYC Program? 2018 2019 2020 2021 2022 Has this sailor participated in a Junior Sailing Program other than PYC?* Yes No Please provide details — e.g., program name, sailing level (beginner, intermediate, advanced), type(s) of boats sailed.Does this sailor have any boating experience other than Junior sailing?* Yes No Please provide details — type(s) of boat(s), degree of involvement (passenger, Some crew work, steering, etc.)Does this sailor take any prescription medications?* Yes No list name, frequency, and dosage of each medication*Does this sailor have any allergies to medications or food?* Yes No Please list by type and symptoms that could indicate an allergic Episode*Are there any conditions that could limit this sailor’s ability to participate in the full range of program activities?* Yes No If you answer Yes, please contact the Junior Program Director, at junior.director@pycme.net for a confidential discussion of the condition and what accommodations might be made to enable your sailor to participate. The Portland Yacht Club Junior Sailing Program will make every effort to make accommodation. However, the Club may deny participation if in its sole judgment the Club believes the risk of injury to the child is high even with an accommodation.Sailor 4 InformationSailor First Name or Nickname Sailor Last Name Sailor Email Sailor’s Date of Birth MM slash DD slash YYYY Weight in pounds (approximate)Please enter a number from 30 to 180.T-SHIRT SIZEEach sailor will receive a PYC Junior Sailor t-shirt. Please select the best fit from the list below.Shirt SizeChoose oneChild SmallChild MediumChild LargeAdult Extra SmallAdult SmallAdult MediumAdult LargeAdult Extra LargeHas your sailor previously participated in PYC Jr Sailing?* Yes No Don’t Know Select the most recent program level of participation Minnows (one week, half day) Beginner (two weeks, half day) Beginner/Novice (two weeks, full day) Intermediate Green Fleet Advanced Race Team Add any comments you may have about PYC ParticipationIn what years did this sailor participate in the PYC Program? 2018 2019 2020 2021 2022 Has this sailor participated in a Junior Sailing Program other than PYC?* Yes No Please provide details — e.g., program name, sailing level (beginner, intermediate, advanced), type(s) of boats sailed.Does this sailor have any boating experience other than Junior sailing?* Yes No Please provide details — type(s) of boat(s), degree of involvement (passenger, Some crew work, steering, etc.)Does this sailor take any prescription medications?* Yes No list name, frequency, and dosage of each medication*Does this sailor have any allergies to medications or food?* Yes No Please list by type and symptoms that could indicate an allergic Episode*Are there any conditions that could limit this sailor’s ability to participate in the full range of program activities?* Yes No If you answer Yes, please contact the Junior Program Director, at junior.director@pycme.net for a confidential discussion of the condition and what accommodations might be made to enable your sailor to participate. The Portland Yacht Club Junior Sailing Program will make every effort to make accommodation. However, the Club may deny participation if in its sole judgment the Club believes the risk of injury to the child is high even with an accommodation. PARENT/GUARDIAN INFORMATIONParticipation in the Junior Sailing Program must be authorized by an adult who has legal responsibility for the child, even if payment will be made by someone else. Note: For phone numbers, please use the format (207) 555-1212. For States, use the drop-down list. For ZIP Codes, please use the five-digit format, e.g., 04101.WHO IS REGISTERING THIS SAILOR?* Parent Grandparent Other Relative Guardian Honorific*Choose oneMr.Mrs.Ms.DoctorFirst Name* Last Name* Preferred Phone*Alternate PhoneEmail* Mailing Address* City* State* Choose oneAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP* ZIP / Postal Code Is this sailor* A child of a PYC Member A grandchild of a PYC Member A child of a PYC Applicant on the Waiting List None of the Above Name of Member or PYC Membership applicant Member # PLEASE LIST TWO CONTACTS IN EVENT OF EMERGENCY (OTHER THAN YOURSELF):FIRST EMERGENCY OPTION:Full name* Relationship to Your Sailor*Choose oneParent (Other than registrant)GrandparentAunt/UncleBrother/SisterOther RelativeFriendPreferred Phone*Alternate PhoneSECOND EMERGENCY OPTION:Full name* Relationship to Your Sailor*Choose oneParent (Other than registrant)GrandparentAunt/UncleBrother/SisterOther RelativeFriendPreferred Phone*Alternate Phone COMMUNICATIONYour e-mail address is automatically added to the PYC Junior Sailing mailing list for newsletters and other general communication. If you would like other family members, guardian or caregiver added to our list, please add their information below. Please alert those you enter that you have included their email addresses. We are allowed to send mail only to those who are willing to receive it.Name E-Mail Address Name E-Mail Address Name E-Mail Address Name E-Mail Address Name E-Mail Address Does Your Family Own a Boat?* Yes No What type, size, etc. What kind of boating do you do? (Check all that apply) Day Boating Cruising Racing Fishing Other PROGRAM SELECTION While the STEM option may be attractive to sailors of any age, only those meeting the prerequisites for the Adventure program may register for a STEM session. Each program shows the typical age range of participants. As they grow in skills and experience, they move up to the next level. However, some sailors may not have the skills and experience to fit in a program for their age group. If that is the case for your sailor, please call the Junior Sailing Director, (207) 781-9820. Here is the full schedule as a reference: Session 1: 2 weeks Mon 6/26 - Fri 7/7 Session 2: 2 weeks Mon 7/10 - Fri 7/21 Session 3: 2 weeks Mon 7/24 - Fri 8/4 Session 4: 2 weeks Mon 8/7 - Fri 8/18 Minnows: 1 week Mon 8/21- Fri 8/25 Half-day AM or half-day PM Race Team: 8 weeks Mon 6/26 - Fri 8/18 Please select Program and Session(s) Session 1: 2 weeks (6/26-7/7) Session 2: 2 weeks (7/10-7/21) Session 3: 2 weeks (7/24-8/4) Session 4: 2 weeks (8/7 - 8/18) Untitled* PRAM BEGINNER MORNING (Ages 7-8) - HALF DAY Beginner AM Session 1 Beginner AM Session 2 Beginner AM Session 3 Beginner AM Session 4 PRAM BEGINNER AFTERNOON (Ages 7-8) - HALF DAY Beginner PM Session 1 Beginner PM Session 2 Beginner PM Session 3 Beginner PM Session 4 OPTI BEGINNER / NOVICE (Ages 9-11) - FULL DAY Opti Beginner/Novice Session 1 Opti Beginner/Novice Session 2 Opti Beginner/Novice Session 3 Opti Beginner/Novice Session 4 OPTI INTERMEDIATE / ADVANCED (Ages 10-12) - FULL DAY Opti Intermediate/Advanced Session 1 Opti Intermediate/Advanced Session 2 Opti Intermediate/Advanced Session 3 Opti Intermediate/Advanced Session 4 OPTI GREEN (Ages 9-12) - FULL DAY Opti Green Fleet Session 1 Opti Green Fleet Session 2 Opti Green Fleet Session 3 Opti Green Fleet Session 4 ADVENTURE (Ages 12-17) - FULL DAY Adventure Session 1 With STEM Adventure Session 2 With STEM Adventure Session 3 Adventure Session 4 420 (Ages 10-17) - FULL DAY 420 Session 1 420 Session 2 420 Session 3 420 Session 4 MINNOWS (Ages 6-7) - HALF DAY (8/22-8/26) Minnows AM Minnows PM Travel Race Teams 6/27 - 8/19. (8-week commitment recommended). We expect to have both Opti and 420 Race Teams. Race Staff will discuss with the sailor’s parent to decide which team would better fit the sailor’s skills and interests. Race Team HiddenTravel Race Teams 6/27 - 8/19. (8-week commitment recommended). We expect to have both Opti and 420 Race Teams. Race Staff will discuss with the sailor’s parent to decide which team would better fit the sailor’s skills and interests. Race TeamAny special notes about your program/session selections? OPTI RACE BOAT CHARTER PYC has a limited number of Optis available for charter for race team participants, available on a first come-first served basis. The charter includes one of the club's newest Opti with class legal sails. The cost will be $500. No pro-rating will be done if your sailor does not use the boat for the entire 8-week program. Check “Yes” below to have a chartered Opti. If none are available, we will let you know. YesPARENT SUPPORT FOR RACE PROGRAM I understand that as a parent or guardian of a participant in a Race Program, I am expected to provide volunteer support for the regattas both “home” and “away.” Support may include (but is not limited to) hauling race boats and/or equipment to a regatta or chaperoning my sailor’s team at a regatta. If there are obstacles or reasons why you would be unable to volunteer for some or all activities, please explain below. I AM ABLE TO VOLUNTEER Yes No PROGRAM PRICE AND FEESPlease consult the tables below to determine the price for the program and session(s) you have selected. Rates are good through April 31. Registration price increases by $20 per session for registrations received after April 31. A nonrefundable registration fee of $50 is due updon registration. Use the Member Price rows if the sailor is the child or grandchild of a PYC member or a person on the PYC Waiting List. There is a special discounted price for full-day Session 1 program. Use the Non-Member Price rows for all others. Race Team prices are based on the full 8-week program. Some adjustment will be made for those whose commit is less than the full session. Members Session 1 (discounted) $540.00 1 session other than session 1 $705.00 3 sessions $1,945.00 4 sessions $2,430.00 Race Team $2,430.00 Half Day 1 session $475.00 Half day-3 sessions $1,330.00 Half day-4 sessions $1,645.00 Minnows $260.00 Non Members Session 1 (discounted) $715.00 1 session other than session 1 $815.00 3 sessions $2,250.00 4 sessions $2,855.00 Race Team $2,855.00 Half Day 1 session $540.00 Half day-3 sessions $1,490.00 Half day-4 sessions $1,890.00 Minnows $285.00 Find the price for the session(s) you have selected.* HOW TO PAYPAYMENT BY MEMBERS When your sailor has been confirmed, the Junior Sailing Program fee will be billed to your member account. The charge will appear on your monthly statement. PAYMENT BY NON-MEMBERS You may pay by check or credit card. The link to PLASTIQ to pay securely online by credit card is on our website or call our Sheri Berk, Bookkeeper the contact for payment questions instead of me. NOTE: in addition to the program fee, PLASTIQ charges up to 2.5% for credit card processing. Checks should be made payable to "Portland Yacht Club” and mailed to 40 Old Powerhouse Road, Falmouth, ME 04105. CONSEQUENCE OF LATE PAYMENT If payment is not made on time, you risk losing the registration slot, which could then be filled from our waiting list. No sailor will be allowed to begin the program until payment has been made in full. REFUNDS A complete refund will be granted if the request is made more than four (4) week prior to the program start date. A 50% refund will be granted if the request is made four (4) weeks or less prior to the start of the program. A 25% refund will be granted if the request is made two (2) weeks or less prior to the program start date. No refunds will be granted after the program start date. No refund will be granted if a sailor is dismissed due to behavorial misconduct for violations of safety requirements. In the case of all refunds, PYC will keep $50 to cover the administrative costs. For questions regarding your invoice and payment, please contact Kelley Rich, PYC Club Manager, at (207) 781-9820 Ext. 10, . To withdraw your sailor from the program and request a refund, please contact Junior Program Director junior.director@pycme.net. To be sure you receive your refund in a timely manner, please copy the Club Manager.I understand and agree to these payment terms.* Yes Who is responsible for payment?* Parent/Guardian Listed Earlier Different Person Name of person responsible for Payment E-mail of person responsible for payment* Address Street Address City State / Province / Region ZIP / Postal Code AUTHORIZATIONSI authorize the Portland Yacht Club to use photos or video of my child in our brochures, web site, or other material.* Yes No I certify that all of the information on this registration form is current and correct. I acknowledge that I have read and understand the mission and purposes of the Junior Sailing Program. I acknowledge that the Portland Yacht Club may deny entry into the Junior Sailing Program for any reason it deems sufficient. I also understand that the Club may suspend or terminate my child’s participation in the Junior Sailing Program for any violation of the rules of the Program or the rules of the Club. I authorize the staff and volunteers of the Portland Yacht Club to obtain emergency medical treatment for my child if that should become necessary. I understand that I will be responsible for payment for any such emergency treatment. I acknowledge that participation in the sport of sailing or in any activity, regatta or event sponsored and/or sanctioned by the Portland Yacht Club Junior Sailing Program may involve substantial risk to my child's body. I hereby waive and release any and all right and claim that I or my child may have against Portland Yacht Club, its officers, directors, agents, servants, employees, and members, for any and all injuries suffered by my child arising out of his or her participation in the PYC Junior Sailing Program. This includes traveling to, participating in, or returning from an event sponsored and/or sanctioned by the Junior Sailing Program. I further agree that my child and I will abide by the rules of the Portland Yacht Club while on its premises. As consideration for the Portland Yacht Clubʼs acceptance of my child to participate in the Junior Sailing Program, I hereby agree to indemnify and hold harmless Portland Yacht Club for any damage which my child, his or her boat, or crew, may cause to any boat or equipment whether owned outright by PYC or leased or borrowed for the Junior Sailing Program. I promise, covenant and agree to be fully liable for all costs and expenses for any and all property damage or loss to both real and/or personal property caused by the intentional or negligent act of my child.PARENT/GUARDIAN CONFIRMATION By clicking “I understand and agree” below, I signify that I agree to the terms and conditions above. Typing my name in the field below the box is the equivalent of my signature.* I understand and agree.Please type your name* Date Authorized* MM slash DD slash YYYY Second Parent or Guardian (Optional) I understand and agree.Please type your name Date Authorized MM slash DD slash YYYY Total Fees Credit CardCredit Card Cardholder Name