TSS Youth Sailing, Inc.
2011 SUMMER SAILING CLASSES
REGISTRATION FORM
For more information or to register by phone:
Call (813) 956-1642
Class dates are on a first come-first sail basis
June 13-17
July 4-8
 July 25-29
June 20-24
July 11-15
 August 1-5
June 27-July 1
 August 9-13
July 18-22
Monday - Friday    9:00 am - 3:00 pm
One Student - $250
Two Students - $450 ($225 each) or 1 student, 2 weeks - $450
Three Students - $600 ($200 each) or 1 student, 3 weeks - $600
Students do not have to be related to qualify for the multiple student group discount but they must be
registered and paid as a group.  
Student #1
Name
Date of Birth
Student MUST be 7 or older by June 1, 2011
Address (no PO Boxes, please)
Zip Code
City
 State
Telephone #
Email
Cell Phone #
Medical, Physical or Behavioral Considerations
Emergency Contact Name
Returning Student?
 Yes
No
Previous Course Dates
Previous Sailing Experience?
Basic
 Advanced
None
Swimming Ability?
Advanced
None
Basic
(Sailing classes are not suitable for students who cannot swim or are afraid of the water.)
Student #2
Name
 Date of Birth
Student MUST be 7 or older by June 1, 2011
Address (no PO Boxes, please)
Zip Code
City
 State
Telephone #
Email
Cell Phone #
Medical, Physical or Behavioral Considerations
Emergency Contact Name
Returning Student?
 Yes
No
Previous Course Dates
Previous Sailing Experience?
Basic
 Advanced
None
Swimming Ability?
Advanced
None
Basic
(Sailing classes are not suitable for students who cannot swim or are afraid of the water.)
Student #3
Date of Birth
Name
Student MUST be 7 or older by June 1, 2011
Address (no PO Boxes, please)
Zip Code
City
 State
Telephone #
Email
Cell Phone #
Medical, Physical or Behavioral Considerations
Emergency Contact Name
Returning Student?
 Yes
No
Previous Course Dates
Previous Sailing Experience?
Basic
 Advanced
None
Swimming Ability?
Advanced
None
Basic
(Sailing classes are not suitable for students who cannot swim or are afraid of the water.)
I hereby acknowledge that participation in the sailing and/or racing program poses certain inherent risks which cannot be
avoided and acknowledge that we are accepting those risks.  In consideration of participating in the T.S.S. Youth Sailing Inc.
Program and being aware of the risk of active sports, I agree to indemnify and hold harmless TSS Youth Sailing Inc., its
summer sailing program and its officers, management, directors, employees, and volunteers from any actions, expenses, or
liabilities which may directly or indirectly arise from the student’s participation  in the sailing program, including, but not
limited to, the use of watercraft, and all facilities and equipment, onshore or on the water, including, but not limited to,
hoists, ramps, trailers, or other means of launching craft.   I certify that, to the best of my knowledge, the student has
basic swimming ability, is in good physical condition and suffers from no physical, behavioral, emotional or mental condition,
which would adversely affect his/her ability to safely participate in sailing activities.  
A $15 per 1/2 hour aftercare fee will be charged after 4 p.m.
I have read the above disclaimer and
 agree
 disagree with its contents.
I have read the above disclaimer and
 agree
 disagree with its contents.
I have read the above disclaimer and
 agree
 disagree with its contents.
FLORIDA REGISTRATION# CH20470  A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE
OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE.  
REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.