CARDIFFBAY YACHT CLUB

Ferry Road, Grangetown, Cardiff, CF11 0JL Admin Tel: 029 2066 6627

Email:

CHILDRENS COURSESSEPT 2013-2014

BOOKING/CONSENT FORM

Course Title / MEMBERSHIP NUMBER
Date of Course / From: / To:
Hours of Course / From: / To:
Cost of course / £ per child / Temporary membership fee: / £

Child’s Details (Please PRINT )

Surname / Forename(s) / Date of Birth / Age
Applicant
Address / Previous address
(if less than 3 years at current address)
Post Code
Contact E-Mail
Has your child taken a Dinghy Sailing Course at the club before? / YES / NO
If YES, give details e.g. Level achieved

To be completed by those who have not previously attended a course at the CBYC

Please confirm the following details:
You are confident in the water / YES / NO
You can swim 50 meters / YES / NO
Do you have any previous sailing experience / YES / NO / If YES, levels achieved

Will your child be using their own Dinghy?

If yes: MAKE ______NAME ______SAIL No. ______

Declaration: I hereby acknowledge that I have read the conditions of participation overleaf and that I fully understand them. I have explained them to my child, who understands and agrees to abide by them.

Signed by Parent or Guardian: …………………………………………………………………………………….

Print name: …………………………………………………………………………………………………

Date: ……………………………………………

Training sessions will be delivered by CardiffBay Yacht Club in accordance with RYA training centre guidance, and staffed by appropriately qualified and experienced RYA instructors.

Booking Conditions

  1. Cardiff Bay Yacht Club reserves the right, at all times, to cancel bookings at our discretion.
  1. All participants MUST be between the ages 7* and 16, wear the buoyancy aid provided and be confident in the water.
  1. All bookings are accepted on the understanding that any instructions or directions given by any member of the centre’s staff are to be observed. Participants are asked to respect the equipment provided; compensation will be sought from anyone deliberately causing damage to equipment.
  1. Cardiff Bay Yacht Club reserves the right at all times to refuse or restrict the use of facilities. The right is also reserved to evict anyone who refuses to comply with the conditions as stipulated, or who behaves inappropriately or, in any way, causes damage or annoyance to any other persons.
  1. Participants are to wear suitable clothing (no jeans) and footwear when going on a boat. Suitable footwear means flat soft soled shoes or trainers. Please bring a change of clothing as sailing can be wet.
  1. If any injuries are sustained or damage to valuables occurs, participants are to notify the centre’s staff immediately.

7. Email address supplied will be used to send regular club news. Please tick the box to opt out.

Membership:

As we are only able to accept members on the courses, if your child does not have their own membership, or is not covered by your membership, your child will need to take out: either a 1st year temporary membership (as stated below) or, if this is their second year on the course, they will need to apply for a permanent Junior Membership.

1st YEAR TEMPORARY MEMBERSHIP £30.00for the year (please sign below)

SUMMER CAMPS / DAYTIME COURSES £5.00per week (please sign below)

TEMPORARY MEMBERSHIP:

As the Club can only accept Members onto the course you will need to read and sign below applying for temporary membership for your child. This will cover you for the days/evenings your child is attending the course

On behalf of (Childs name)______I ______(your name) hereby apply for temporary membership of PMB & SC Ltd t/a Cardiff Bay Yacht Club Limited, subject to the provisions of the Memoranda and Articles of Association and agree if accepted and so long as(Childs name) ______remains a member to conform to the rules of PMB & SC Ltd. t/a Cardiff Bay Yacht Club Limited as now existing or as varied hereafter.

SIGNED………………………………………………………

DATED…………………………………………………

(To be signed by Parent/Guardian on behalf of child)

CBYC DECLARATION

Parent/Guardian/person with legal responsibility

Full Name: / Relationship:
Home Number / Mobile Number:
Alternative Parent/Guardian/person with legal responsibility
Name: / Relationship:
Home Number / Mobile Number:
.

It is your responsibility to make known any disability/medical condition that may affect your child during the activity, and any medication that they may require. This information will be shared with those responsible for supervising the activity

Has the competitor suffered from any of the following conditions? Please provide details for “Yes” answers

Provide details and specific medical
Details / Yes/ No / advice to be followed in
emergency.
Asthma/bronchitis, Heart conditions, Fits, fainting or / Yes/No
blackouts, Severe headaches, diabetes.
Is your child taking any medication? / Yes/No
When did your child have a tetanus vaccination? / Year:
Does your child have any allergies that we need to know
about ? / Yes/ No
Is your child suffering from any injuries which may affect their / Yes/ No
sailing?
Does your child have any disability, learning difficulties or
medical condition which may effect their learning (theory or / Yes / No
practical)

Declaration of parent or person with legal responsibility Risk Statement

Sailing is by its nature an unpredictable sport and therefore inherently involves an element of risk.

By allowing my child to participate in the event and racing I, the parent/guardian of the child mentioned above agree and acknowledge that:

a)I am aware of the inherent element of risk involved in the sport and accept responsibility for exposing my child to such inherent risks;

b)I have satisfied myself that my child has the necessary skill and knowledge to take part in the event and to deal with conditions that may arise.

c)I am responsible for ensuring that my Childs boat is in good order, equipped and insured (including third party insurance of at least £3 million).

d)I am responsible for my child’s property whether afloat or ashore;

e)I accept responsibility for any injury, damage or loss to the extent caused by my own actions or omissions or actions or omissions of my child;

f)When racing the provision of a race management team, patrol boats and other officials and volunteers does not relieve me of my parental/guardianship responsibilities or my child of his/her responsibilities;

g)When racing the provision of patrol boat cover is limited to such assistance, particularly in extreme weather conditions, as can be practically provided in the circumstances;

j)When racing my child is bound by the Conditions of Entry, Notice of Race, Sailing Instructions and Racing Rules of Sailing (save as amended by the Notice of Race or Sailing Instructions). I have explained them to my child, who understands and agrees to abide by them.

Medical consent

I give permission to administer any relevant treatment or medication to the above-named

participant when or if necessary.

In an emergency situation I authorise the organisers to take my child to hospital and give my full

permission for any treatment required to be carried out in accordance with the hospital’s diagnosis. I

understand that I shall be notified, as soon as possible, of the hospital visit and any treatment given

by the hospital.

Supervision (** delete one option as appropriate)

*I will be responsible for my child throughout the event/ course. I will be available at the event venue.

*I appoint the person named below, who has agreed to act in loco parentis. During this time, he/she will be responsible for my dependent and will be available at the Club. Please inform the Head coach should this change on the day.

………………………………………………………………………………………………………………………

Conditions of Use of photography or video

In accordance with our child protection policy, CBYC will not arrange for photographs, video or other

images of young people to be taken or published without the consent of the parents/guardians and

children. We will abide by the Conditions of Use below. If you have any concerns about the way

images are being used, you should inform the chief Instructor or General Manager immediately.

  1. We will normally only identify a child by reference to the child’s first name.
  1. We will not use personal details or full names (ie. first name and surname) of any child to accompany a photographic image on video, on our website, in our organisation brochure or any other electronic or printed publications without good reason. ‘Good reason’ includes using the full name of a child in a newsletter to organisation members if the child has won a trophy or award.
  1. We will not include personal email or postal addresses, telephone or mobile numbers on video, on our website, in our organisation brochure or in other electronic or printed publications.
  1. We may use group photographs or video with very general labels, such as ‘Youth Training”.
  1. We will only use images of children who are suitably dressed, to reduce the risk of such images being used inappropriately.
  1. Photographs or video may be used for coaching purposes or by officials to illustrate incidents on the water.
  1. Commercial sale of any form of media will be limited to the organisers or their official photographers.

Consent for use of images

*I grant to the organisers without payment the right in perpetuity to make, use and show any motion pictures, still pictures and live, taped or filmed television of or relating to the event.

*I have read and understood the Conditions of Use

*

* I agree to notify the Club of any relevant changes in my child’s circumstances. I confirm that my child is not under a court order.

Signed: (participant) ………………………………………………………………………………………..

Signed: (parent/guardian)………………………………………………………..…………………………

Name: (please print) …………………………………...... Date: …………………..

Signed: (person appointed in loco parentis) ………………………………………………………………

Name: (please print)………………………………………………………….. Date: ……………………

Contact telephone/mobile: …………………………………………………………………………………

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