Juniors Registration – Newport Yacht Club

Select Camp Sessions*

Please select a session. If the session is full, you can place your child on a wait list for that session or choose another session.

Session 1: June 28 - July 10 (registration is closed!)
Session 2: July 12 – July 23 (registration is closed!)
Session 3: July 26 – August 6 (registration is closed!)
Session 4: August 9 – 20

Child's Information

Child's Name*

First Last

Child's Gender*

Female
Male

Child's Birthdate*

(mm/dd/yyyy)

Parent/Guardian Information

Parent/Guardian Name (primary contact)*

First Last

Parent/Guardian Email*

Enter Email Confirm Email

Home Phone*

Cell Phone*

Home Address*

Street Address Address Line 2 City State ZIP Code

Additional Contact Information (1)

Please provide the name and phone number of another parent, guardian, family member or neighbor who can be contacted if we are unable to reach you. Please state their relationship to the child.

Contact Name*

First Last

Phone for Contact*

Contact's Relationship to Child*

Additional Contact Information (2)

Please provide the name and phone number of another parent, guardian, family member or neighbor who can be contacted if we are unable to reach you. Please state their relationship to the child.

Contact 2 Name*

First Last

Phone for Contact 2*

Contact 2's Relationship to Child*

Health Information

Child's Doctor Name*

Doctor's Phone Number*

Allergies or Health Concerns*

No allergies or health concerns
Yes

Please contact the General Manager Rudy Borgueta at 401-846-9410, extension 4, so that he is aware of the medical issue.

Additional Questions

How would you rate your child's swimming ability?*

Has your child attended at Newport Yacht Club junior sailing program before?*

Yes
No

Does your child have previous sailing experience?*

Yes
No

Adult Sailing lessons*

Would you be interested in learning more about Adult sailing classes for yourself?

Yes
No

How did you learn about us?*

Consent and Payment

Parent/Guardian Consent*

As the parent/guardian of the named individual for whom application is being made to Newport Yacht Club, I, the undersigned, agree to indemnify and hold blameless the Newport Yacht Club, their officers, directors, members, affiliates, employees and volunteers.

I agree

Photo Release*

Newport Yacht Club has my permission to use my or my child’s photograph publicly to promote ONLY the NYC Junior Sailing Program. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

I agree

Session Fee

Price:

Additional Buffs?

All campers will get ONE buff/neck gaiter per session for sun and hygiene protection that we require to be worn when outside their group. Would you be interested in ordering additional buffs as spares, for yourself, or friends/family? They cost $15 and proceeds benefit the program. If so, help us determine how many to pre-order by giving an estimate.

Total

$0.00

Notes for Staff

Is there anything you would like the staff to know?

Payment Method*

Please indicate payment method. If you are requesting a scholarship, someone will contact you to obtain additional information.******PLEASE ONLY CLICK "SUBMIT" ONE (1) TIME*****

Credit Card
Discount Code

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Billing Address*

PLEASE CLICK "SUBMIT" ONLY ONE (1) TIME

Same as home

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Discount Code*