Your (Parents) Name *

First Name

Last Name

Sailor's Name *

First Name

Last Name

Winter Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Summer Address

Leave blank if same

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Sailor's Date of Birth *

MM

DD

YYYY

Please Choose Weeks to Enroll *

Week of 7/2

Week of 7/9

Week of 7/16

Week of 7/23

Week of 7/30

Week of 8/6

Week of 8/13

Week of 8/20

Second Class Weeks to Enroll

Week of 7/2

Week of 7/9

Week of 7/16

Week of 7/23

Week of 7/30

Week of 8/6

Week of 8/13

Week of 8/20