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Bucks Harbor Yacht Club

...more than a century of tradition in beautiful Brooksville, Maine

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JSP Town Resident Registration

JSP Town Resident Registration

The BHYC junior sailing program is offered free of charge to year-round Brooksville residents who are not members of BHYC nor related to members of BHYC. Any child who attends Brooksville Elementary School or who is a home-schooled year-round resident of Brooksville is invited to register. Additionally, any current student attending GSA who is a former student at Brooksville Elementary School is also invited to register.
Student Name*
Is this the first time that this student has been registered for this season?*
- Yes
- No
If yes, please fill out all required contact and medical information.
Parents' Names*
Parent's Email*
Student's Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone*
Alternate Phone
Select Class From List*
- Ballast (Mon-Thu 8:15-10:15 am)
- Apprentice Helmsman (Mon-Thu 8:15-10:15 am)
- Helmsman (Mon-Thu 1:30-4 pm)
- Skipper (Mon-Thu 10:30 am-12:30 pm)
- Senior Skipper (Mon-Thu 10:30 am-12:30 pm)
- Opti Race Team (Tue, Thu 10:30 am-12:30 pm)
- 420 Race Team (Mon, Wed, Thu, Fri 1:30 pm-4:30 pm)
- Harbor Rookies (Fridays, 9:30-10:45 am OR 11 am-12:15 pm)
*Sailors in Skipper or above may participate in the 420 Race Team. BHYC sends a fleet of 3 boats (6 sailors) to a few regattas each summer. Boat pairings and regatta teams are determined by the race coach. Race Team meets Monday, Wednesday, Thursday, and Friday 1:30-4:30.
Select Weeks
- June 24th
- July 1st
- July 8th
- July 15th
- July 22nd
- July 29th
- August 5th
- August 12th
Select Time for Harbor Rookies*
- 9:30 am-10:45 am
- 11 am-12:15 pm
Date of Birth*
MM
DD
YYYY
Height in feet and inches*
Weight*
Date of last tetanus shot?*
Allergies*
Check all that apply
- None
- Medicines
- Plants
- Foods
- Insect Bites
Please list specific allergies*
Medications
List medications, if any, that your child is currently taking
Medical Information*
Please check all that apply
- None
- Asthma
- Epilepsy
- Circulatory/Heart Problems
- Hemophilia/Bleeding Problems
- Diabetes/Hypoglycemia
- Eyeglasses/Contact Lenses
- Hearing Aides
- Surgeries/Illnesses
- Other
Please describe specific medical issue*
Health Insurance Carrier*
Policy Number*
Pediatrician*
Pediatrician Phone*
Name of emergency contact #1*
Emergency contact #1 phone*
Name of emergency contact #2*
Emergency contact #2 phone*
In case of emergency, I understand that every effort will be made to contact me. In the event that none of the above listed contacts can be reached, I authorize the staff of Buck's Harbor Yacht Club to obtain medical treatment for my child. By entering my initials below, I give my consent.
Photo Consent*
I give permission for uncaptioned images (photos, videos, etc.) of the above named sailor to appear on BHYC social media such as the website or facebook page:
- Yes
- No
Additional Information?
Please let us know if there is anything we need to know that is not included in the registration.
By typing in initials below, parent or guardian of the above named sailor understands and agrees that the junior sailor is participating in the Buck's Harbor Yacht Club Sailing Program at his/her own risk, and hereby releases the Club, its members, agents, and employees from all actions, causes of action, damages, claims, or demands which may arise against such parties for any and all injuries caused by or resulting from participation in the program. The undersigned recognizes there are risks associated with the sailing program and, understanding those risks, choose to have the junior sailor participate.
Initials*
Type initials above

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Bucks Harbor Yacht Club

Steamboat Wharf Road
Brooksville, ME 04617
207-326-0556

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