Name

Email *(optional - we may send you occasional promotional messages but will not share with any third parties).

Address

Post Code

Name and Phone number of contact in case of Emergency

User Agreement

Medical Fitness Declaration
I confirm that I am fit and able to participate in watersports activities and I have not been advised against physical activity by a doctor.

Please give any medical details or conditions we should be aware of

User Agreement

Accident Liability Declaration 
I accept that any activity and tuition is undertaken at my own risk and that Harlow (Blackwater) Sailing Club, its members and visitors, will not in any way be held responsible for any personal injury resulting from use of the premises, equipment and facilities provided by the Club and its members.

Agreed by parent/guardian if under 18 or responsible adult where necessary

Date