St Aubin’s Fort Watersport Centre

Adult Courses from September 2012

RYA Day Skipper/Coastal Skipper*

Course code: 2027 Cost £350 – email or telephone for more information 10th to 14th September, starting 0900 and finishing 1800

RYA Powerboat Level 2 Course Code: 2028 Cost £154

15th and 16th September, 0900 to 1700 each day Course Code: 2029

13th and 14th October, 0900 to 1700 each day

RYA Powerboat Instructor* Course Code: 2030 Cost £345

12th to 14th October, 0900 to 1800 each day

RYA Competent Crew Course Code: 2031 Cost £350 22nd to 26th October, starting 0900 and finishing 1800

RYA First Aid Course Course Code: 2032 Cost £45

13th and 14th November (evenings) 1800 to 2130 each day

RYA Sea Survival Course Course Code: 2033 Cost £132

30th September, 0900 to 1700

RYA Advanced Powerboat Course* Course Code: 2034 Cost £214

24th and 25th November 1000 to 1900

Courses marked with * have pre-requisites. Details of all courses can be obtained by emailing s.pearl@gov.je or telephone 449808 / 449617. Venues and joining instructions will be sent with confirmation. Please complete booking form overleaf and send, together with payment, to Sports Development, Fort Regent, St Helier, JE2 4UX.

Name: Date of Birth:

Home Address:

Post Code:

Tel. Day: Tel. Eve:

Emergency Contact Name & Tel. Number:

Please let us know about any medical treatment and/or medication that may affect your participation:

All courses have limited availability and are offered on a first come, first served basis. Early booking is advised. Sports Development reserves the right to cancel or amalgamate classes where necessary. Please note that requests for refunds must be made in writing to the Sports Development Officer at least one week before the course start date. Please list your course requests below:

Course Code Activity Description Amount

Method of payment: Cheques should be made payable to “Treasurer of the States”.Or Credit/Debit card number

CVV

Valid From / Expiry Date / Issue No.

Name of Cardholder

Cardholder’s Signature Date:

Please return to: Sports Development, Fort Regent, St. Helier, Jersey, JE2 4UXData Protection Law (Jersey 2005). The information provided by you on this form is required by the Sport & Leisure Division for the purpose of course enrolment and coaching requirements. Children’s information supplied by you may be disclosed to sports coaches. Financial details provided will be securely disposed of at the end of each course.

ADULT COURSE APPLICATION FORM