Online Registration Form

When registering online your information will be sent electronically to the Sailing Center Registrar.

A Separate form must be filled out for each participand and program!

Program and Session Desired (select one):

All Programs:

Participant Information:

First Name
Last Name
Phone
Street Address
City
State
Zip
E-mail (required)
School Attended (if applicable)
Where did you here about us?
If refered by a Friend, Name:
Promotion Code (brochure back)

Complete this section if participant is under 18 years of age:

Participant's Date of Birth
Parent 1 First Name
Parent 1 Last Name
Parent 1 Day Phone
Parent 2 First Name
Parent 2 Last Name
Parent 2 Day Phone
If parents can not be reached, please give information of a person to notify in case of emergency
Name
Relationship
Day Phone
Camp Bus Service Desired	Yes	No	Available for two-week camps only
If yes, Which stop
If bus service is used, it is the parents responsibility to deliver or pick up the participant at the appointed time and place. The bus driver can not wait and the Baltimore County Sailing Center, the Bus Driver and Bus Company are absolved of any and all responsibility.
Summer Camp Participants must have a current immunization record on file before attending camp.

All must read and complete this section

Are there any medical or other health factors that might affect you / your child's performance in this activity?
	Yes	No
Are you / your child taking any medications that might affect your / your child's performance in this activity?
	Yes	No
Are there any medical or other health related problems which we should be aware of?
	Yes	No
Does the participant have a disability which requires an accommodation?
	Yes	No
Please explain any "YES" answers to the above questions in detail:

Two ways to pay:

Mail your check to:
   BCSC Registrar
   P.O. Box 34134
   Essex, MD 21221-8134

Or check here to
Request E-mail bill:

By registering online, you understand that the Sailing Center is not responsible for lost electronic registrations and in no way guarantees flawless electronic transfers.

Web Design By: Kent Schellinger