You are here: Home Youth Open Training 2-3 March
Open Training March 2-3

Personal Details

 Please note: All required fields are marked with an *
Name * Invalid Input  Sailing Club * Invalid Input Class * Invalid Input Sail Number * Invalid Input
Date of Birth * Invalid Input Height (cm) * Invalid Input Weight (kg) * Invalid Input Gender * Invalid Input
How long have you been sailing / racing? * What are your best results? What certificates or badges do you have?
Invalid Input Invalid Input Invalid Input
Welsh Skills
Understand * Invalid Input Read * Invalid Input
Speak * Invalid Input Write * Invalid Input

Contact Details
Email Address * Invalid Input Postal Address * Invalid Input
Home Telephone No. Invalid Input
Mobile No. Invalid Input Postcode * Invalid Input
Parents' or Guardians' Phone Numbers:- Work Invalid Input Work Invalid Input
Mobile Invalid Input Mobile Invalid Input

Volunteers needed!
Please note all parents/guardians will be asked to sign up to a rota to keep the club clean and tidy at the end of the day.
Name Qualifications / Skills offered
Invalid Input Invalid Input
Invalid Input Invalid Input

Medical Details
Doctor * Invalid Input Telephone No. * Invalid Input
It is your responsibility to make known any potential medical conditions that may affect you during the activities associated with the programme you will be taking part in. Please therefore provide as many details as possible. This information will be shared with the coaches at events and training.
Have you ever suffered from any of the following conditions:
  Asthma / Bronchitus * Invalid Input Heart conditions * Invalid Input Fits, fainting or blackouts * Invalid Input
Severe headaches * Invalid Input Diabetes * Invalid Input Travel sickness * Invalid Input
Allergies to Medication * Invalid Input Any other allergies * Invalid Input Other illnesses or disabilities * Invalid Input
If you have answered yes to any of the above, please provide details: Invalid Input
If you are currently taking any medication, please specify: Invalid Input
If you are suffering/recovering from any injuries which may affect your involvement with the programme, please specify: Invalid Input
If you are vegetarian or have any food allergies, please specify: Invalid Input
Consent Please get a parent or guardian to read the following declaration and fill in the rest of the form.
As the parent/guardian of the person named above, I give permission, to the Clwb Hwylio Pwllheli Sailing Club appointed supervisor, to administer to the named person, any treatment or medication when or if necessary.
Further, if the case arises I authorise the Clwb Hwylio Pwllheli Sailing Club appointed supervisor to take the named person to hospital and give my full permission for any treatment required, to be carried out in accordance with the hospital’s diagnosis. I understand that I shall be notified, as soon as possible, of the hospital visit and any treatment given by the hospital.
Parent / Guardian Name * Invalid Input Date * Invalid Input

Calon Hwylio Cymru ~ Heart of Welsh Sailing

Scroll to Top