Brooke Gonzalez Advanced Racing Clinic Payment Form

Sailor Name(Required)

First Last

Sailor Email(Required)

Sailor Phone(Required)

Date of Birth(Required)

Age During Clinic(Required)

Shirt Size(Required)

The sailors will receive a shirt or something similar. The sizes are UNISEX

Parent/Legal Guardian Name(Required)

First Last

Parent/Legal Guardian Email(Required)

Parent/Legal Guardian Phone(Required)

Membership Information

Send me Membership Information

Parent/Legal Guardian Address(Required)

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

I am the sailor's(Required)

Mother

Father

Legal Guardian

Chaperone Name(Required)

First Last

Chaperone Email(Required)

Chaperone Phone(Required)

Type of Boat and Position(Required)

Sailing Partner Name(Required)

First Last

Sail Number

I will be brining my own boat(Required)

Sail Newport does not provide charters. If you need a charter please reach out to Nick Ewenson.

Yes

No, I have a charter

Please list Food Allergies or Dietary Restrictions below(Required)

Please write in N/A if this does not apply to you.

Special Medication or other Pertinent Information(Required)

Please write in N/A if this does not apply to you.

Does the sailor have a history of, or currently have, any physical or other limitations that might prevent or challenge their full participation?(Required)

Please write in N/A if this does not apply to you.

CONSENT

I, the parent/legal guardian of the minor sailor, acknowledge and consent to the following:

I verify that my child can swim 20 yards and tread water for 3 minutes.

WAIVER OF LIABILITY

I acknowledge that my child intends to participate as a youth sailor in the Brooke E Gonzalez Advanced Racing Clinic, hosted by Sail Newport in Fort Adams State Park. I specifically assert that the minor sailor will comply with the RRS of Sailing and rules and regulations of the event. I will make certain that my child is provided with a Coast Guard approved life jacket, or home country equivalent and will wear it at all times while on the docks or on the water. I am aware that participation in a sailing event presents the risk of serious injury and even death and assume said risks for my child with respect to practicing or participating in a Sail Newport sailing event either on the water, on the docks or on shore. I agree to indemnify and hold harmless the State of Rhode Island, Sail Newport Inc., and their respective officers, directors, members, affiliates, employees, sponsors, staff, volunteers and helpers for all claims of any persons for damages or personal injury whatsoever that may be sustained or caused by my child while participating in any activity of Sail Newport, Inc., or using Fort Adams State Park. In accordance with section 7-6-22 of the Rhode Island General Laws, entitled "EXEMPTION FROM LIABILITY."

MEDICAL AUTHORIZATION

I the parent or legal guardian of the above named, a minor, do hereby authorize and consent to such medical or dental treatment services or care which are necessary or appropriate for my child, including the selection of medical personnel and facilities and transportation or transfer of my child to such facilities and in connection with such treatment, services and/or care, to authorize and consent in my name and on my behalf to such emergency or necessary surgery, diagnostic or corrective, as they may determine to be necessary for the life, health or wellbeing of my child, after reasonable consultation with duly licensed physicians, surgeons and /or dentists. It is understood that reasonable effort shall be made to contact the undersigned prior to rendering treatment of my child but that any of the above treatment will not be withheld if the undersigned cannot be reached.

CONSENT TO BE PHOTOGRAPHED

I understand that by my child participating in a Sail Newport program or regatta, it automatically grants to Sail Newport, any organizing authority and its sponsors the right in perpetuity to make, use and show, from time to time at their discretion, any motion pictures and live, taped or filmed television and other reproductions of him or her during the period of the program and competitions without compensation.

ASSUMPTION OF THE RISK

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself, my child(ren)(including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I, and my child(ren) may experience or incur in connection with their attendance at SN or participation in SN programming (“Claims”). On my behalf, and on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless SN, DEM, and The State of Rhode Island, their employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of SN, DEM, or the State of Rhode Island, their employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any SN activity.

Brooke Gonzalez Advanced Racing Clinic Payment Registration

Financial Aid Application