2018 Training - Online Booking

Please enter Student's Details here

Course Type:
If "Other" is selected, please specify:

Preferred Dates:
Student's Name:
* Required *
Contact Email:
* Required *
Student's Address:
Mobile Number:
Land Line:
Previous Experience:
Swimming Ability:
Any Medical Conditions:
Date of Birth:
CBC Club Member:
(Yes or No)

Please enter Parent / Guardian Details here (if student is over 18 enter Next of Kin)

Parent / Guardian / Next of Kin Name:
* Required *
Postal Address:
Mobile No:
Home Number:
Shore contact while in Clifden:

* Required *

Guardian should be contactable during course time in case of any unforeseen events.

Would you like to be included in the "Sunday Sailing Text Alert":
(Yes or No)
Photos may be used for promotion of club activity and on social media.
If you DO NOT wish for photos to be used, please type NO:
Are you interested in receiving emails from the Irish Sailing Association:
(Yes or No)
Will you require lunch at The Boardwalk Cafe:
(Yes or No)


Printed form, can be posted to: Pascal Marinot, The Old School House, Kingstown, Clifden, Co. Galway

You can also pay by "Pay Pal".
You will be emailed confirmation of availability and paypal details on receipt of this online booking.