Participation Agreement:

I, ____________________________________________, will participate in the IYC Adult Sailing Lesson Program. I agree to indemnify and hold harmless the instructors and leaders of these programs, the Inverness Yacht Club and its Officers, Directorsand Employees, and absolve them of any responsibility should an injury occur to me, notwithstanding any fault or neglect of any of them. I further agree to be responsible for and promptly reimburse the IYC for any damage that may be done to IYC boats or facilities used by me.

I further give permission for me to receive medical treatment from any licensed physician in the event of an emergency.

I have the following allergies, medical or special learning conditions:

________________________________________________________________________________________

________________________________________________________________________________________

I understand that acceptance of me as a student in the Adult Sailing Lesson Program of the Inverness Yacht Club is subject to:

[a] Space availability.
[b] The demonstrated ability of the student to pass a swimming qualification.
[c] The requirement that the student must provide and wear a Coast Guard approved Type III life jacket.
[d] The student following the direction of the Program Instructors and Staff.
[e] The understanding that drugs or alcohol consumed before or during an Adult Sailing lesson will result in dismissal.

In case of emergency, please notify:

Name: ________________________________________ Phone:_____________

Name: ________________________________________ Phone: _____________

Applicant Name: ________________________________

Applicant Signature: _____________________________ Date _________________

This Form Must Accompany Application