2026 Safety at Sea

Safety at Sea

Saturday, June 6, 2026
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
Course communications and your certificate of completion will be sent here.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Yacht Club*
US Sailing Membership #
Comments
If you want to be grouped with others, please share a boat or group name and we will try to accommodate.
Medical and Emergency Information

All Information provided below will remain Confidential.
Date of Birth

MonthDayYear
Date
Name of Primary Care Physician*
Phone Number*
Please enter a valid phone number.
Health Insurance Carrier*
Health Insurance ID Number*
Name of Emergency Contact (someone not attending the course with you) *

First NameLast Name
Relationship*
Phone Number *
Please enter a valid phone number.
If you have any medical conditions the Safety at Sea Moderators should know about, please list below. If none, fill in "none". *
Example: respiratory problems, circulatory or heart problems, diabetes or hypoglycemia, bleeding problems, epilepsy/seizure, other.
If you have any allergies, please list below. If none, fill in "none".*
If you have allergies, do you carry an EPI Pen?

YesNo
Date of last Tdap (Tetanus/Diptheria/Acellular Pertussis) Shot:*

MonthDayYear
Date
Current Medications and Dosage, if any. If none, fill in "none".*
If there's any additional health information the Safety at Sea Moderators should know about, please provide details.
Release Agreement: I acknowledge that the hands-on training to be provided with the Safety at Sea course will necessarily include inherent risks, including those from flame, flares and water. I hereby assume those risks. I will follow all instructions provided in the seminar and hereby release the Organizers and Macatawa Bay Yacht Club from any liabilityor any claims that I might otherwise have because of my participation in this training event. I sign this release knowingly and of my own free will.
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Safety at Sea in-person June 6, 2026
$395.00 Quantity

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Cancellation: After registering, you may cancel for a partial refund (your registration fee less $35 processing) prior to May 20. Cancellations received after May 20 are not eligible for refund.
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Safety at Sea

Medical and Emergency Information