Booking Form - Nelson Yacht ClubNelson Yacht Club

If you would prefer to complete a hard copy, you can download a PDF of the booking form here: NYC Booking Form-2017-18

Please complete and return to Nelson Yacht Club, 322 Wakefield Quay, Nelson, 7010.

Otherwise, please complete this online form. If you have any questions, call Tim on 02102503767.

If you are human, leave this field blank.

Course / Product *

Course Date & Time *

Participant's Previous Experience *

Participant's Current School (If Applicable)

How did you hear about us? *

Contact Details

Participant's First Name *

First

Participant's Last Name *

Last

Date of Birth *

Age at start of course/activity

(If under 18)

Gender *

Water Confidence *

Please disclose any relevant medical details *

Anything that we need to be aware of when we have you/your son/daughter here at the club or on the water?

NYC Membership Number (If Applicable)

Parent/Guardian's Name

For any participants <18yrs

Address *

Address Line 2

Email *

Home Phone

Mobile Phone *

Parents of youth members

Work Phone

Occupation

Emergency Contact

We require at least one Emergency Contact or Next of Kin.

Emergency Contact Name *

Who should we call in the event of an emergency

Relationship to the participant *

Emergency Contact Number *

Emergency Contact Number 2

Booking Terms & Conditions - Please read carefully

Full balance and a completed, signed booking form is required to secure a booking. You/the participant should be confident in the water and able to swim at least 50m in a Buoyancy Aid (PFD). You must advise us on this booking form of any relevant illness, injury, medical condition or disability that you/the participant are affected by. Whilst it may not necessarily prevent you/the participant from taking part in the course/activity, Nelson Yacht Club cannot accept any responsibility for any accident/incident stemming directly or indirectly from a participant's medical condition. You agree that you/the participant are responsible for any loss, damage, injury (including death) or accident to yourself or others whilst on a course/lesson, renting equipment or visiting the site. You agree that you/the participant are solely responsible for any damage to equipment/infrastructure that occurs as a consequence of action or inaction by you/the participant and that you shall be liable for the cost of necessary repairs and any corresponding loss in value. Cancellation/Postponement by Nelson Yacht Club Nelson Yacht Club reserves the right to cancel a course/booking at any time if viable numbers are not achieved or if weather conditions are not suitable. Where we have to cnacel a coruse, another set of dates will be arranged asap, at mutual convenience. Cancellation by Client If notice of cancellation is given less than 30 days before the start of the course, 100% of the course fee is retained. Any course/hire booked is valid for a maximum of 12 months from the date of booking. Courses/hire not taken within 12 months will be forfeited. *

I have read and understood the Terms and Conditions above and agree to abide by them

Photographic Model Release From time to time, representatives of Nelson Yacht Club and//or it's contractor Nelson Watersports Limited may take photographs or video of sailing activity and use them for promotional purposes. If you do not wih your/your child's picture to be used in this way please tick this box

I do not wish for photographs or videos of me or my children to be used for promotional purposes.

Privacy Nelson Yacht Club and Nelson Watersports Ltd will not distribute your contact details to any third party without your prior permission. However, we would like to send you information on upcoming courses and club news and events. If you do not wish to receive this newsletter, please tick this box

I do not wish to receive email newsletters from Nelson Yacht Club or Nelson Watersports Ltd

Fees

Fee are payable to Bank Account 03 0703 0474907 00. Please use the Participant's Last Name as a reference. Or post cheque to Nelson Yacht Club, 322 Wakefield Quay, Nelson

I have transferred fees to NYC Bank Account

I have posted a cheque

Parent / Guardian Consent Declaration (For under 18s) Please sign / type your full name below

I, the parent/guardian of the child named above, consent for my son/daughter to participate in Nelson Yacht Club activities. I have made Nelson Yacht Club aware of any relevant medical conditions that affect my son/daughter. I hereby give consent for Nelson Yacht Club Instructors to administer any relevant treatment or medication to the named participant as directed if/when necessary.

Date *

Contact Details

Emergency Contact

Booking Terms & Conditions - Please read carefully

Fees

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