STUDENT INFORMATION
Student (first & last name) (*)
Student name is required
Age (*)
Please enter a valid age
Address
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City
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Province
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Postal Code
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Home Phone (*)
Please enter a home phone number
COURSES
Optimist – White Sail 1 and 2
Select a course level
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Select Course Dates
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Are you a
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Squadron - White Sail 3
Course level
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Select Course Dates
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Are you a
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Bronze Sail 4 and 5
Course level
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Are you a
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Silver Sail 6
Course level
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Are you a
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Tennis
Please specify number of weeks ($20/week)
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REGISTERING PARENT INFORMATION
First and Last Name (*)
Please enter parent name
BYC Member #
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Work/Day Phone (*)
Please enter a work/daytime phone number
Cell Phone
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Email address (*)
Please enter a valid email address
Payment Method (*)
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CREDIT CARD PAYMENT INFORMATION
(As shown on your credit card statement)
Upon submission of this application, you will be transferred to a secure payment page to enter your credit card number, expiry, etc.
Name of Cardholder (*)
Cardholder name is required
Billing Address (*)
Address is required
City (*)
City is required
Province
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Postal Code (*)
Postal code is required
Email Receipt To (*)
Please enter a valid email address
TERMS & CONDITIONS
I understand that it is a condition of participation in this program that I do so at my own risk and that I do not suffer from
any physical or emotional disorder that could adversely affect my safety. I recognize that sailing can be a dangerous
sport and assume all risk of injury, loss or damage to my person and/or property while upon the property or vessels
owned, leased and/or under the care and control of Britannia Yacht Club, its servants and/or agents. Furthermore, I
relinquish any and all claims against Britannia Yacht Club, their executive, members, servants and/or agents for any
injury, loss or damage to my person and/or property while upon the property or vessels owned, leased and/or under the
care and control of Britannia Yacht Club, their servants or agents.
I understand and accept the above stated terms & conditons (*)
Acceptance of the terms is required
Security Code
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