Sailing Program Registration | TIPYC | Thousand Island Park Yacht Club

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Student Information

Complete this information for each student. Required fields are marked with an asterisk.

If you prefer to register by mail or in person, please use this form (PDF). Note that the registration is not complete until we confirm receipt of the signed form and payment.

Student Name *

FirstLast

Date of Birth *

Student’s Date of Birth

Mobile Phone

The student’s mobile number is not required but helps our instructors contact them.

Parent or Guardian Information

A parent or legal guardian must provide this information. Required fields are marked with an asterisk.

I understand that by putting my name in the field below, I am signing this form electronically.

Primary Parent or Guardian *

FirstLast

Primary Email *

EmailConfirm Email

Primary Phone *

Mobile phones are preferable.

Other Parent or Guardian

FirstLast

Other Email

EmailConfirm Email

Other Phone

Mobile phones are preferable.

Address *

Address Line 1CityStateZip Code

Review and Sign Agreements

The parent or guardian must read and agree to both the Accident Waiver and Release of Liability Agreement as well as the Youth Sailing Participation Agreement & Code of Conduct. Please check the “I have read and agree to the terms” below. Also, make sure you discuss the Code of Conduct with your child. I understand that by putting my name in the Parent or Guardian field above, I am signing this form electronically.

Accident Waiver and Release of Liability Agreement *

I have read and agree to the terms.

Participants, Parents, and Guardians hereby consent to participation in any and all events sponsored by Thousand Island Park Yacht Club, Inc. (TIPYC) or held at TIPYC property and do hereby waive any and all claims for personal injury or property damage, as well as any derivative claims, against TIPYC and its staff, volunteers, or Members of the Board.

PARTICIPANTS, PARENTS, AND GUARDIANS HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH TIPYC INCLUDING BUT NOT LIMITED TO SAILING PROGRAM, VOLUNTEER ACTIVITIES, RACING AND SOCIAL EVENTS, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons, or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. Understanding the risk, Participant is permitted to participate in all such activities.

Participants, Parents, and Guardians acknowledge that the Participant must pass a sailing proficiency test and ONLY then may he/she sign out a TIPYC sailboat during specified times. Individual sailboat usage requires preregistration and completion of a detailed float plan with TIPYC staff .

Participants, Parents, and Guardians certify that the Participant is physically fit, is physically and mentally capable of participation in this activity, has sufficiently prepared or trained for participation in this activity, and has not been advised to not participate by a qualified medical professional. Participants, Parents, and Guardians certify that there are no health-related reasons or problems which preclude the Participant’s participation in this activity. Participants, Parents, and Guardians further certify that if they have any doubts whatsoever about the Participant’s ability to safely participate, they will consult with their own health care provider, at their expense, and Participant will refrain from participating, or Participant will participate solely to the limited extent recommend by their health care provider.

Participants, Parents, and Guardians acknowledge that this Accident Waiver and Release of Liability Form will be used by TIPYC and its employees, agents, trustees, sponsors, and organizers of the activity in which the Participant may participate, and that it will govern his/her actions and responsibilities at said activity.

In consideration of the application and permitting Participant to participate in this activity, Participants, Parents, and Guardians hereby take action for Guardian, the Participant, and each’s executors, administrators, heirs, next of kin, successors, and assigns as follows:

(A) Participants, Parents, and Guardians hereby freely and voluntarily waive, release, and discharge from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for Participant’s death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to the Participant including travel to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: The TIPYC and/or its directors, trustees, officers, employees, volunteers, representatives, and agents, and the sponsor of the activity, as well as those individuals running or holding the event and those volunteering at the event;

(B) Participants, Parents, and Guardians recognize the inherent danger in water sports in general and sailing in particular and assume the risks and hazards associated with all of the activities conducted by staff or participants of TIPYC, as well as the condition of any equipment or premises under the control of the TIPYC. Participants, Parents, and Guardians hereby waive any and all claims for personal injury, property damage, loss of consortium, as well as any derivative claims against TIPYC including its directors, trustees, officers, employees, representatives, and agents arising out of the Participant’s participation that the Participant, Guardian, Guardian’s spouse, dependents, heirs or beneficiaries may have or acquire against TIPYC. Participants, Parents, and Guardians recognize and understand that Participant may suffer or otherwise incur physical injury and /or experience impairment of the Participant’s health and/or exacerbate an existing health or medical condition through voluntary participation in TIPYC events and/or use of TIPY property. Participants, Parents, and Guardians understand that such injuries and/or impairments to Participant’s health could be both serious and substantial and could even result in permanent incapacitation or death.

(C) Participants, Parents, and Guardians indemnify, Defend, Hold Harmless, and Promise not to Sue the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.

(D) Participants, Parents, and Guardians pledge the Participant will not knowingly misuse TIPYC property or damage such property. Participants, Parents, and Guardians further pledge and agree that if Participant discovers that an item of TIPYC property is damaged or malfunctioning, Participant will immediately discontinue use and promptly report malfunction or damage to the TIPYC directors, trustees, officers, employees, volunteers, representatives, or agents.

Participants, Parents, and Guardians acknowledge that TIPYC and its directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any third party or entity conducting a specific activity on their behalf.

Participants, Parents, and Guardians acknowledge that this activity may involve a test of a person’s physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers.

Participants, Parents, and Guardians pledge and agree that if at any time during participation the Participant experiences any symptoms, conditions or injuries whatsoever that cause us to be concerned for the Participant’s health or wellbeing, Participant will immediately discontinue participation and immediately seek emergency medical care if warranted under the circumstances.

Participants, Parents, and Guardians understand while participating in this activity, the Participant may be photographed. Participants, Parents, and Guardians agree to allow the Participant’s photo, video, or film likeness to be used for any legitimate purpose by the TIPYC as well as the activity holders, producers, sponsors, organizers, and assigns.

Participants, Parents, and Guardians understand that Participant is under no obligation to participate, and Participant is free to stop participation at any time. Participants, Parents, and Guardians further understand that they may rescind this Release at anytime by demanding that the original be returned, whereupon Participant will be prohibited from participating until and unless a new Release is completed in the manner required by TIPYC.

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

Participants, Parents, and Guardians are 100% liable for all medical expenses incurred as a result of any injury or property damage during the Participant’s participation in TIPYC activities.

PARTICIPANTS, PARENTS, AND GUARDIANS CERTIFY THAT THEY HAVE READ THIS DOCUMENT AND FULLY UNDERSTAND ITS CONTENT. PARTICIPANTS, PARENTS, AND GUARDIANS ARE AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND ACKNOWLEDGE ACCEPTANCE OF IT OF THEIR OWN FREE WILL.
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IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER TIPYC FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO, OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY PROGRAM AFFILIATED WITH TIPYC, THE PARTICIPANTS HEREBY AGREE TO THE FOLLOWING:

THE PARTICIPANTS HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS TIPYC, its directors, officers, employees, volunteers and agents from any loss, liability, damages or costs which they may incur, related to any cause whatsoever while the Participants or the participating child is in, upon, or about the TIPYC premises, facilities or equipment or participating in any program affiliated with TIPYC. The Participants understand and agree that TIPYC is not required to provide insurance to cover the Participants or such participating child in the event they suffer illness, injury, death, property loss, theft or damage of any sort, upon or about the premises or any facilities or equipment therein or participating in any program affiliated with TIPYC. Any insurance of the Participants shall be primary;

The Participants on his or her own behalf, and on behalf of such participating child, agree and acknowledge that use of TIPYC facilities and services, and participation in TIPYC programs, may involve inherent danger and risk, including, without limitation, the risk of physical illness or injury, death or property damage. THE PARTICIPANTS ON HIS OR HER BEHALF AND ON BEHALF OF SUCH PARTICIPATING CHILD HEREBY ASSUMES FULL RESPONSIBILITY FOR ALL RISK OF ILLNESS, BODILY INJURY, DEATH OR PROPERTY DAMAGE to the Participants or such participating child; and

THE PARTICIPANTS further expressly agree that the foregoing ASSUMPTION OF RISK, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State of New York and that if any portion thereof is held invalid, it is agreed that the balance of the Agreement shall, notwithstanding, continue in full legal force and effect.

THE PARTICIPANTS HAVE CAREFULLY READ AND VOLUNTARILY AGREE TO THIS ASSUMPTION OF RISK, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE.

PARTICIPANTS UNDERSTAND THAT THIS AGREEMENT MAY BE ON BEHALF OF A MINOR.
PARTICIPANTS, PARENTS, AND GUARDIANS HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH TIPYC INCLUDING BUT NOT LIMITED TO SAILING SCHOOL, VOLUNTEER ACTIVITIES, RACING AND SOCIAL EVENTS, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons, or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. Understanding the risk, Participant is permitted to participate in all such activities.

Participants, Parents, and Guardians acknowledge that the Participant must pass a sailing proficiency test and ONLY then may he/she sign out a TIPYC sailboat during specified times. Individual sailboat usage requires preregistration with TIPYC teaching staff (by phone or in person) and completion of a detailed float plan.

Participants, Parents, and Guardians acknowledge that this Accident Waiver and Release of Liability Form will be used by TIPYC and its trustees, employees, agents, sponsors, and organizers of the activity in which the Participant may participate, and that it will govern his/her actions and responsibilities at said activity.

(A) Participants, Parents, and Guardians hereby freely and voluntarily waive, release, and discharge from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for Participant’s death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to the Participant including travel to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: The Thousand Island Park Yacht Club, Inc. (TIPYC) and/or its directors, trustees, officers, employees, volunteers, representatives, and agents, and the sponsor of the activity, as well as those individuals running or holding the event and those volunteering at the event;

(B) Participants, Parents, and Guardians recognize the inherent danger in water sports in general and sailing in particular and assume the risks and hazards associated with all of the activities conducted by staff or participants of TIPYC, as well as the condition of any equipment or premises under the control of the TIPYC. Participants, Parents, and Guardians hereby waive any and all claims for personal injury, property damage, loss of consortium, as well as any derivative claims against TIPYC including its officers, employees, trustees, and agents arising out of the Participant’s participation that the Participant, Guardian, Guardian’s spouse, dependents, heirs or beneficiaries may have or acquire against TIPYC. Participants, Parents, and Guardians recognize and understand that Participant may suffer or otherwise incur physical injury and /or experience impairment of the Participant’s health and/or exacerbate an existing health or medical condition through voluntary participation in TIPYC events and/or use of TIPY property. Participants, Parents, and Guardians understand that such injuries and/or impairments to Participant’s health could be both serious and substantial and could even result in permanent incapacitation or death.

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

Participants, Parents, and Guardians are 100% liable for all medical expenses incurred as a result of any injury or property damage during the Participant’s participation in TIPYC activities.

ADDITIONAL ASSUMPTION OF RISK, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT DUE TO COVID-19 PANDEMIC EMERGENCY

IN CONSIDERATION for being permitted to utilize the services and programs of the Thousand Island Park Yacht Club, Inc. (“TIPYC”) and/or for my child to participate in any program affiliated with TIPYC and/or to use the facilities or equipment of TIPYC, the parent/guardian, on behalf of himself or herself and the participating child, as well as any personal representatives, heirs, and/or next of kin (hereinafter collectively referred to as the “Participants”) hereby acknowledges, agrees and represents that he or she has had an opportunity to inspect and has carefully considered such premises, equipment and facilities and/or the affiliated programs and that the Participants finds and accepts same as being reasonably safe and suited for the use or participation by the Participants and such participating child.

In addition, the Participants acknowledges that novel coronavirus (“COVID-19″) infections have been confirmed throughout the United States, including the State of New York and more specifically, Jefferson County, New York. The Participants hereby agree, represent, and warrant that neither the Participants nor such participating child shall visit or utilize the facilities, services, and programs of TIPYC within a 14-day period following (i) exposure to any person who has a suspected or confirmed case of COVID-19, (ii) experiencing any symptoms of COVID-19, including without limitation, fever, cough or shortness of breath, or (iv) a suspected or diagnosed/confirmed case of COVID-19 in the family or household of the Participants or the participating child.

The Participants agree to notify the TIPYC immediately if he or she believes that any of the foregoing access/use restrictions may apply at any time during or following the Participants or participating child’s visitation to or use of the facilities or equipment, or participation in TIPYC programs or services.

TIPYC has taken steps to implement recommended guidance and protocols issued by the CDC and NYSDOH for slowing the transmission of COVID-19, including without limitation, the access/use restrictions set forth above. The Participants acknowledge and agree that TIPYC may revise its procedures at any time based upon and in accordance with updated recommended guidance and protocols issued by the CDC and NYSDOH and further agree at all times to comply with TIPYC’s procedures prior to utilizing the facilities, services, and programs of TIPYC. The Participants further acknowledge and agree that, due to the nature of the facilities, services, and programs offered by TIPYC, social distancing of 6 feet per person among other program participants and program instructors in such an environment may not always be possible. The Participants acknowledge and accept on behalf of themselves and the participating child the known and potential risks of utilizing the facilities, services, and programs of TIPYC and acknowledge that use thereof by the Participants and/or such participating child may, despite TIPYC’s reasonable efforts to mitigate such risks, result in exposure to COVID-19 and all risks attendant to such exposure including, but not limited to, becoming subject to quarantine requirements, serious illness, disability, and/or death.

THE PARTICIPANTS, KNOWINGLY AND VOLUNTARILY ON HIS OR HER BEHALF AND ON BEHALF OF SUCH PARTICIPATING CHILD, FOREVER RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE TIPYC, its directors, officers, employees, volunteers and/or agents for any costs, losses or damages, or to make any claims or demands on account of any property damage, or injury, including but not limited to illness or death of the Participants or such participating child (or any person who may contract COVID-19 directly or indirectly, from the Participants or such participating child) whether caused by the negligence of TIPYC or otherwise, resulting from the Participants or such participating child using the premises, facilities or equipment of TIPYC or participating in any program offered by TIPYC;

PARTICIPANTS UNDERSTAND THAT THIS AGREEMENT MAY BE ON BEHALF OF A MINOR.

Youth Sailing Participation Agreement & Code of Conduct *

I have read and agree to the terms.

Each participant has a responsibility to act in a way that assures a positive experience for all. All participants are required to follow these guidelines and requirements:

All Registration Materials must be complete:
• Registration Form & Payment Accepted
• Acceptance of this Participation Agreement, including Code of Conduct and Liability Waiver

A swim test is required of all first-time students consisting of swimming 50 yards in sailing clothing and footwear.

Proper footwear must also be worn at all times, both on land, in boats, and in the water.

All participants are required to wear a Coast Guard approved, vest-type life jacket that is the proper size for their weight and build so that it is form-fitting and comfortable. Please put the participant’s on the life jacket using waterproof ink.

Behavior Guidelines:

• Participants shall be responsible for their words and actions.
• Participants shall be respectful of others.
• Participants shall follow directions from staff members.
• Participants shall leave all electronic devices at home such as mobile phones and other devices. TIPYC and/or staff are not responsible for lost or damaged devices.

Prohibited Behaviors:

• Endangering the health and safety of themselves, other participants, and/or staff or volunteers through words or actions which might be disruptive or distracting.
• Stealing, damaging, or failing to care for yacht club or personal property.
• Continual disruption of the program.
• Refusal to follow the behavior guidelines.
• Inappropriate physical contact.
• Using profanity or inappropriate language or displaying clothing or other personal items with offensive content.
• Bullying or acts of aggression or violence.
• Possession or use of illegal substances, tobacco, or alcohol.
• Possession of weapons – any object that may cause harm to another, or place another person in fear of his/her safety, may be considered a weapon.

Disciplinary Actions:

When a participant doesn’t follow behavior guidelines, the following steps may be taken:
• Counselor will redirect the participant to a more appropriate behavior.
• The participant will be reminded of the behavior guidelines.
• If the behavior persists, staff will discuss the problem with a parent/guardian.
• The staff will document the situation. The written documents will include what the behavior problem is, what provoked the problem, and the corrective action taken.
• If the problem persists to the point where a second phone call becomes necessary, the Program Director may find it necessary to have the participant picked up early from the Sailing Program.
• If a participant’s behavior at any time threatens the immediate safety of him/her, other participants, or staff, the parent/guardian will be notified and expected to pick-up the child immediately.

Failure to comply with the Code of Conduct may result in the removal from the program and/or additional fees. There will be no refunds given for participants who are removed from the program due to violations of the Code of Conduct.

By registering in the program, registrants, parents, and guardians agree that they have read, understand, and accept this Code of Conduct. Furthermore, they agree to obey all program rules as set forth by the program director, instructors, counselors, and this document. They also agree to use utmost care in the use of the boats and equipment, and will not engage in any horseplay or other disruptive behavior. They understand that failure to arrive promptly and abide by the rules may result in my suspension from the program without refund of payment.

Participants, parents, and guardians assume full responsibility for any loss or damage, excepting loss or damage covered by insurance, that may come to any person, boat, sailboat, equipment, pier, float, or other property used in conjunction with this course as the result of improper use, negligence, violation of the rules, and other acts of sailors, or other representatives of the program, instructional program, or host location in connection herewith. Registrants, parents, and guardians accept that the sport of sailing and the conduct of this course entail and are subject to certain inherent risks and assume all risks on land and on the water of participation in this program. They further agree to hold the TIPYC, program, instructional program, or host location, and their representatives harmless for personal injuries and/or property damage.

Parents/Guardians understand the contents of this statement and agree to see to it that their child adheres to the program rules. They agree to assume the obligation for the expenses of repair and/or replacement of program equipment that is attributable to their child’s reckless or irresponsible behavior and agree to make an appointment for a parent-instructor conference, if requested.

Your Signature *

Clear Signature

Select the Sessions

Select the session(s) you would like to register the student. Make sure you select the right time — mornings (9:30a-12p) are for children ages 8-12 and afternoons (1-3:30p) are for youth ages 12-18.

Session *

Registration is on a first-come, first-served basis. Classes are generally about 16 sailors. We do our best to accommodate everyone. If a session is full (e.g., Morning July 8-11), you may have the option to put your name on the waiting list for $1.

Consider a Contribution

We are no longer a membership organization so all can participate. Would you consider making a tax-deductible donation to support our programs? Every donation counts! Also, consider volunteering this summer.

Contribution Levels

Other AmountMinimum Price: $10.00

Volunteer Opportunities

I’d like to volunteer with food/drinks
I’d like to volunteer with races
I’d like to volunteer elsewhere

Other VolunteerTotal Due *

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Quantity
Qty

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Transaction Fees

$0.00

Total

$0.00

$0.00Transaction Fees *Fee: $0.00To offset increasing costs, we are adding 3.5% to every card transaction.

Complete Payment

Provide credit/debit card information and click submit to complete the payment process. If you previously provided us with a card, you may receive a message with a verification code to speed up your payment process.

After payment is processed, you will receive an email confirming the student’s registration. If you made a charitable contribution, you would receive an additional acknowledgment for your tax records.

Stripe Credit Card *

The Thousand Island Park Yacht Club is a volunteer-run, registered 501(c)(3) charitable nonprofit organization. Donations to the TIPYC are tax-deductible to the full extent of the law. If you have any questions related to your contributions or instructions for submitting a matching gift, please contact us.