Parent's Name

Street Address

City State ZIP

Phone                   E-Mail

Sailing Certificate From:

Racing Class:          Optimist                   Sunfish

I , am the parent or guardian of the above named sailor and grant full permission for him/her to participate in this event. I further certify that I have completed the release forms that are necessary for my child to take part in this Youth Sailing Program event.

Signature

Registration Fee: $10 (Includes T-shirt & Picnic)

Please mail this form, fee and release forms (if not already completed) to:

Colington Yacht Club
c/o Don Dow
228 Outrigger Dr
Kill Devil Hills, NC 27948

Questions: 252-480-1934 or YouthProgram@ColingtonYachtClub.com