Chicago Corinthian Yacht Club
Crew Development Program
Please complete the entire form. If there any questions contact James Janik at
DrJanik@juno.com, cell-773.301.3440, home- 773.286.8739.
Address________________________ Evening Phone_____________________
City__________________________ State/Zip__________________________
E-Mail Address_________________ Age______
Have you sailed before? _________ Have you raced on a sailboat before?___
Please enclose $95.00 course fee. Make checks payable to Chicago Corinthian Yacht Club and send payment to:
James Janik
5256 West Warner
Chicago, IL 60641
I heard about the class from: ( ) friend ( ) The Reader ( ) Tribune ( ) flyer ( ) ccyc club member (?)______________ ( ) other__________________
Classes begin at 7pm at Chicago Corinthian Yacht Club @ 601 W. Montrose Avenue on April 18, 2007.
I, recognize that an element of risk is involved in all water sports, including sailing. Therefore, to induce Chicago Corinthian Yacht Club (CCYC) to accept my enrollment in the Crew Development Program, I covenant and agree to release CCYC, its officers, directors, members, instructors and agents (collectively and individually) from any and all claims losses, fees, damages and liability arising out of, or related in any manner to my participation in the program. I understand and agree that this release will be valid even if the claim loss, damage or liability results from negligent acts or omissions of CCYC
Signature X__________________________________________ Date__________________
Print Name_________________________________________________________________________________