Course & Club Boat use Registration – Island Cruising Club of Salcombe

Title 1

First Name 1

Surname 1

Email 1

D.O.B 1

Address 1

Address 2

Address 3

Post Code

Home Tel. No

Mobile Tel. No.

RYA Qualifications Held

Emergency Contact Details :- Name

Emergency Contact Details:-Tel. No.

Emergency Contact Details:-email

Course Start Date if booked

Course Required if booked

Any Medical conditions that could affect sailing/training for any member

Any food Allergies for any member

Food Allergies{summary}

Can you Swim 50 meters (Yes/No)

No. of years Yacht Sailing experience

No. of days Yacht Sailing in last year

Emergency Contact Doctor:- Name

Emergency Contact Doctor:- Tel No

Your are signing to accept the Island Cruising Club Terms and Conditions. https://www.islandcruisingclub.com/island-cruising-club-conditions-and-membership

Signature By

Confirmation of Signature

Select to Confirm signature

Date (DD/MM/YY)