Malta Young Sailors Club
APPLICATION FORM
BEGINNERS BASIC SAILING COURSE 2010
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CHILD’S DETAILS
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FIRST NAME
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SURNAME
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DATE OF BIRTH
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SEX
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PARENT’S DETAILS
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FATHER’S NAME
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MOTHER’S NAME
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ADDRESS
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E-MAIL ADDRESS(es)
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TELEPHONE HOME
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TELEPHONE WORK
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MOBILE FATHER
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MOBILE MOTHER
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MOBILE CHILD (if any)
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Please state preference of Course below i.e. 1st, 2nd, 3rd or 4th in the empty box next to the Course number.
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Course 1 Monday & Thursday from 0900 - 1300 |
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Course 2 Monday & Thursday from 1400 - 1800 |
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Course 3 Tuesday & Friday from 0900 - 1300 |
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Course 4 Tuesday & Friday from 1400 - 1800 |
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Applications are to be sent to the Club Secretary:Ms.Anna Rossi “Bremen “ Triq Bachillier, San Pawl tat-Targa, Naxxar. E-mail: arossi@orbit.net.mt Mobile:99494657
Permission to publish photos and indicate names of my child in the Malta Young Sailors Club publications.
I GRANT CONSENT___________ I REFUSE CONSENT______________
Signature: _____________________________________ Date: ______________
MYSC collects personal information for the use of confirming our client program details such as communicating time-tables and information about activities of the club.
