"*" indicates required fields Contact InfoName of Person Filling out Form* First Last Email* Student Name*Is this the first time that this student has been registered for either the sailing or the tennis 2026 season?* Yes No If yes, please fill out all required contact and medical information.Parents' Names*Parent's Email* Student's Summer Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary Phone*Alternate PhoneClass Weeks and RegistrationClasses Schedule Harbor Rookies (M,W,F 11-12:15) Ballast (Mon-Thu 8:15-10:15 am) Apprentice Helmsman (Mon-Thu 8:15-10:15 am) Helmsman (Mon-Thu 1:30-4:00 pm) Skipper (Mon-Thu 10:30am-12:30 pm) Senior Skipper (Mon-Thu 10:30-12:30 pm) Opti Race Team (Tue & Thu 10:30-12:30) 420 Race Team (Mon, Wed, Thu 1:30 pm-4:30 pm) *Sailors in Skipper or above may participate in the 420 Race Team. BHYC typically 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.Class*Select from ListHarbor RookiesBallastApprentice HelmsmanHelmsmanSkipperSenior SkipperHarbor Rookies Weeks* Week of Jun 22 Week of June 29 Week of June 29 Week of July 6 Week of July 13 Week of July 20 Week of July 27 Week of August 3 Week of August 10 Ballast Weeks* Week of Jun 22 Week of June 29 Week of June 29 Week of July 6 Week of July 13 Week of July 20 Week of July 27 Week of August 3 Week of August 10 Apprentice Helmsman Weeks* Week of Jun 22 Week of June 29 Week of June 29 Week of July 6 Week of July 13 Week of July 20 Week of July 27 Week of August 3 Week of August 10 Helmsman Weeks* Week of Jun 22 Week of June 29 Week of June 29 Week of July 6 Week of July 13 Week of July 20 Week of July 27 Week of August 3 Week of August 10 Skipper Weeks* Week of Jun 22 Week of June 29 Week of June 29 Week of July 6 Week of July 13 Week of July 27 Week of August 3 Week of August 10 Senior Skipper Weeks* Week of Jun 22 Week of June 29 Week of June 29 Week of July 6 Week of July 13 Week of July 20 Week of July 27 Week of August 3 Week of August 10 Student InfoDate of Birth* Month Day Year 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 takingMedical 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*AcknowledgementsIn 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 to all of the following: (1) You and Buck’s Harbor Yacht Club (“BHYC”) have agreed to conduct this registration and release under Maine law by means of this electronic record and your typed initials below evidence your intent to sign and be bound by this record; (2) The junior sailor is participating in the BHYC’s Sailing Program at his/her own risk, and on behalf of the junior sailor and his or her household, we hereby release BHYC, its members, agents, and employees (together the “BHYC parties”) from all actions, causes of action, damages, claims, or demands which may arise against such BHYC parties for any and all injuries or illness caused by or resulting from participation in the Sailing Program, including injuries or illness caused by or resulting from negligence on the part of any such BHYC parties, and no one of us will file or maintain a civil action against any of the BHYC parties asserting a cause of action or claim hereby released; (3) There are inherent risks associated with the Sailing Program and, understanding those risks, chooses to have the junior sailor participate; (4) The junior sailor will not come to participate in any class unless at that time (a) there is no reason to suspect the junior sailor is infectious with SARS-CoV-2 (the virus that causes COVID-19), (b) there is no reason to suspect the junior sailor has had close, recent contact with anyone infectious with that virus, and (c) the junior sailor and his or her immediate household have complied with quarantine or other requirements then in effect, if any, applicable to them under any Executive Orders or other laws existing at that time to reduce the spread of COVID-19; (5) You will participate and cooperate with contact tracing if recommended or required by public health officials; (6) You will promptly inform BHYC of any current COVID-19 illness or suspected illness in the junior sailor’s household if the junior sailor has attended any class in the previous couple weeks; and (7) You agree to pay reasonable attorneys’ fees, reasonable paralegal fees, and reasonable costs of collection, incurred by BHYC or a BHYC party, if you breach or violate any of the terms or provisions set forth above, and BHYC and/or the BHYC party prevails in the enforcement of such term or condition in a court of law.Initials*Type initials abovePayment InfoTotal