Houston Yacht Club Phone: 281.471.1255 Fax: 281.471.9260
Youth Sailing Program Registration Form
Male Female Date of Birth:
Cell Phone: Home Phone: Work Phone:
City: State: Zip Code:
Member # Current Member Applying for Membership
Additional Sailing Program:
Events Planning To Attend:
Siblings In Program:
I/We hereby certify and acknowledge that I/We have read all the Conditions and Requirements of the program, including the Liability & Medical Release Forms. I/We agree to all Conditions & Requirements including but not limited to:
Liability Release: The undersigned, as the parent or legal guardian (hereafter referred to in the singular) of the above sailor registrant (herein referred to as the “child”), requests that the child be allowed to participate in the Houston Yacht Club YOUTH ACTIVITIES PROGRAM (herein referred to as the “activities”). These activities include, but are not limited to, sailing programs, practices, training drills, clinics, regattas, camps, and any and all other activities conducted under the auspices of the Houston Yacht Club.
I certify that I have received a copy of the Houston Yacht Club’s Liability Release Form and understand and agree to all of its terms and conditions. I understand that a completed and signed copy of the form must be submitted to HYC to complete the registration process.
Medical Release: I certify that I have received a copy of the Houston Yacht Club’s Medical Consent & Release Form and understand and agree to all of its terms and conditions. I understand that a completed and signed copy of the form must be submitted to HYC to complete the registration process.
Photograph Release Authorization: I hereby consent that any photographer or testimonials, which may have been or may be taken by a photographer or writer, may be used by HYC for the purposes of advertising, promoting or publicity for Houston Yacht Club or its associates and affiliates.
I certify that the information given above is true and correct, and I agree to all the above stated conditions. I also acknowledge that this certification is deemed a valid legal signature.