Start Sailing Registration Form

Mannering Park Amateur Sailing Club Inc

START SAILING REGISTRATION FORM

Course Details: Monday 18th January till Thursday 21st January commencing at 9.00am and finishing at 3.00pm each day
Participants Details (please provide a separate form for each entry)
Name
Age		DOB
Parent/Guardian Name
Address
Suburb		Postcode
Phone Number
Email Address
Alternative Email Address

Parent/Guardian authority form (to be completed if participants are under 18 year of age)
I (Parent/Guardian)		give permission for
Name
to participate in the MPASC Start Sailing 1 & 2 course

Indemnity
Name (please print): (on behalf)
hereby release Mannering Park Amateur Sailing Club Inc. or representative thereof, from any claim or demand that I/we may have or deem to have on my/our behalf arising out of the MPASC Start Sailing 1 & 2 course and indemnify Mannering Park Amateur Sailing Club Inc. or any other representative thereof against any claim that may be made.

I understand that photos may be taken during the course and uploaded to the club website. Please advise the Instructor on the day of the course if you don’t wish photos to be taken of your child.

I agree to be bound by the above Indemnity terms and conditions.
Dated 24/04/24

Please advise health, dietary or cultural issues which you feel are relevant the participant’s application

NOTE: Please advise instructors if your child suffers from any allergies that may require use of an Epi Pen and if they have one, or if they may require an insulin injection as our first aid kits do not contain an Epi Pen or insulin due to prescription requirements.

Payment

(Please select your payment option) for the first child $90. For additional children $80

Direct to Bank - Mannering Park Amateur Sailing Club Inc - BSB: 062 832 ACC#: 10225462
(Please use your surname as the payment reference)

Payment Amount

Payment Reference

Mannering Park Amateur Sailing Club are very proud to be partnered with these Businesses

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