Which week(s) will you be attending? (Note: Week 2 is full!) *

• Week 1: June 12-16
• Week 3: July 10-14

Name *

First

Last

Age *

Parent/Guardian Name *

First

Last

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Phone *

Do you have any sailing experience? If so what? *

Are you comfortable in the water? *

• Yes
• No

Do you give permission to post pictures on our Facebook site or on our website? *

• Yes
• No

Do you have any limitations, restrictions, allergies, or anything we need to know? *

How did you hear about us?

If car pooling is available, would you be interested?

• Yes
• No
• Don't Know

Submit and Pay