Register for the Community Sailing Day on August 2, 2008
at the Lavallette Yacht Club!

Our online form is not working at the moment, if you would like to register, please call 732-505-0202. Once you leave your message please fill out this page, print it and bring with you to the event along with the waiver form.

All volunteers, therapists, LYC volunteers, skippers, and crew MUST have a completed waiver form handed in prior to participating in the Community Sailing Day.

Click Here for Answers to Frequently Asked Questions about Community Sailing Days

Your Name
Client Name (if different)
Are you a family member of the client?

Please enter your address:
Street Address
City
State
Zip
 

Please enter your email address or phone# below:
Email Address
Contact Phone Number

Please check your interests:
Volunteering on land
Sailing as a client
Sailing as crew

Sailing as a skipper

If you will be sailing your own boat, please describe your boat size and type.


Please describe your sailing experience:




If you are sailing as a client or representing a client, please check the following areas that apply to you:

Client is ambulatory without cane
Client is ambulatory with cane
Client requires a wheelchair

Age
Weight in lbs., if lacking lower extremity strength

Please enter any additional pertinent information on your or the client's physical condition:

Please Click "control P" to Print this page and bring it with you to the event. And don't forget to print and fill out the waiver form. Thanks!