Youth Camp Signup (PayPal) Printable paper form: 2018 Youth Camp Registration Send to the P.O. box with a check if using this form. Otherwise, use PayPal below. If you are a human and are seeing this field, please leave it blank. Fields marked with a * are required Summer Camps Youth sailing and water activity camps are held at both Barkers Island Marina and Park Point Sailing Pier. Camp tuition includes lunch and an annual membership to the DSSA (discounted for participants who are already members). Camps are scheduled weekly from 9am – 4pm beginning June 25th and ending August 10th. Contact Info First Name * Last Name * Email * Phone * Address 1 * Address 2 City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * Camp Date(s): * June 25 - 29 (ages 12-16)July 9 - 13 (ages 7-11)July 16 - 20 (ages 12-16)July 23 - 27 (ages 7-11)July 30 - Aug 3 (ages 7-11)Aug 6 - 10 (ages 7-11) Number of participants: * Name(s) and Age(s) of participants: * Sub Total Are any of the above participants current DSSA members? * Yes No How many of the above participants are current DSSA members? * Discount Sailing Experience (none required): Allergies: Other Comments: Support Us! Our lesson & membership fees do not fully cover the cost of providing DSSA programming. If you are able to make a tax-deductible donation to meet or exceed this amount, we greatly appreciate it! The DSSA is committed to providing sailing opportunities for all, regardless of ability to pay. Donation Billing Contact Name: * Billing contact helps us with book keeping and should be the name associated with the PayPal account used for payment. Total NOTE: All members must also fill out the Waiver of Liability and Emergency Contact Document. A parent / guardian signature is required for those under 18 years of age. When you click the "Submit" button below, you will be redirected to PayPal to pay for your lesson.