Junior Sailor First Name:                   Last Name:
Date of Birth: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995
Parent/Guardian First Name:                   Last Name:
Primary Contact Number:   HomeWorkMobile	Secondary Contact Number:   HomeWorkMobile
Email:
Junior Sailing Session: Session 1 - Monday, June 7 - 18, 2010Session 2 - Monday, June 21 - July 2, 2010Session 3 - Monday, July 12 - 23, 2010
Notes:
Would your child be interested in a continuing sailing program to be available on weekends (weather permitting) that is similar to the program we offer during the summer? Yes - Please contact meNo - Not this yearNot sure - I need more information
Would your child be interested in a continuing sailing program that offers training and opportunities to sail in organized competitive sailing events such as regattas? Yes - Please contact meNo - Not this yearNot sure - I need more information

Release and Indemnification: The undersigned parent or natural guardian has enrolled the above listed child in Sailing Lesson(s) offered by The North Texas Sailing School and Rush Creek Yacht Club, which is located at 320 Rush Creek Drive, Heath, Texas 75032 (the "Facilities") and does hereby agree and confirm as follows: 1. I fully recognize the risks of injury or illness inherent in participation in any fitness or athletic program, and I represent to The North Texas Sailing School (NTSS) and the Rush Creek Yacht Club (RCYC) that I have consulted my child's personal physician or other health authority and my child is physically capable of participating in the Sailing Lesson(s). 2. I hereby voluntarily release, discharge, waive and relinquish any and all actions or causes of action for personal injury, property damages, or wrongful death occurring to me and arising as a result of engaging in Sailing Lessons or any activities incidental thereto, wherever or however the same may occur and for whatever period said activities or instructions may continue. I, for myself, my heirs, executors, administrators and assigns, hereby release, waive, discharge and relinquish any action or causes of action aforesaid which may hereafter arise for me and for my estate, and agree that under no circumstances will I or my heirs, executors, administrators and assigns prosecute or present any claims for personal injury, property damages or wrongful death against NTSS and/or RCYC and/or its officers, directors, agents, servants, and employees, from any and all liability of any kind or nature in connection with my participation in the Lessons, whether the same shall arise by the negligence of any said persons, or otherwise. IT IS MY INTENTION BY THIS INSTRUMENT TO EXEMPT AND RELIEVE NTSS and RCYC FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGES OR WRONGFUL DEATH CAUSED BY NEGLIGENCE. 3. I further indemnify and hold harmless NTSS and/or RCYC and/or its officers, directors, agents, servants, and employees, from any and all claims, actions, demands, costs, liabilities, expenses or judgments whatsoever, including attorneys' fees and costs, which might arise from my participation in the Sailing Lesson(s). 4. I hereby voluntarily execute and deliver this Release and Indemnification to NTSS and RCYC to induce NTSS and/or RCYC to permit my participation in Sailing Lesson(s), and I hereby acknowledge that such participation is at my own risk and without any representations of any kind or character having been made by NTSS and/or RCYC and/or its officers, directors, agents, servants, employees, parent company and subsidiaries. I acknowledge that I have read the foregoing and have been fully advised that I should contact my child's personal physician or other health authority prior to commencing the Sailing Lesson(s). By selecting "I Agree", you agree to the terms of this release and indemnification agreement. The full text of this release and indemnification agreement will be included in the confirmation email that will be sent to the North Texas Sailing School and the email address provided above upon registration as a receipt to your class enrollment. Display Entire Release And Indemnification I Accept   I Do Not Accept

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You can also contact Michael Hoye at (972) 771-2002 or send an email to info@northtexassailing.com.