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Welcome Aboard!
We're eager to get to know you

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We're excited to have you join us for an unforgettable experience in the British Virgin Islands aboard the Mooring 433 Powercatamaran. To ensure we meet your needs and make the trip as enjoyable as possible, we kindly ask you to fill out the following information. Your responses will help us plan meals, accommodations, and other arrangements with your comfort in mind.

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Thank you for your time!

Passport Information

While all records are encrypted, for sensitive data such as this PII, our policy is to add another layer of protection to the data at the application level.

Birthday
Month
Day
Year
Date of Issue
Month
Day
Year
Date of Expiration
Month
Day
Year

Crew Travel Information

If you are traveling with another crew member and have the same travel itinerary, feel free to fill out only one form.

Flight/Ferry To Tortola

Date and Time of Arrival
Month
Day
Year
Time
HoursMinutes

Flight/Ferry From Tortola

Date and Time of Departure
Month
Day
Year
Time
HoursMinutes

Dietary Preferences and Allergies

We want to make sure all meals suit your needs. Please provide details about any food preferences or allergies below.

Do you have any food allergies?

Please check all that apply

Do you have any dietary restrictions or preferences?

Please check all that apply

Alcohol and Smoking Preferences

Do you consume alcohol?
Are you a smoker?

Photo Release Form

PERMISSION TO USE NAME AND LIKENESS:

I, the undersigned participant, hereby grant Center Helm LLC and its affiliates, employees, agents, and representatives, the irrevocable and unrestricted right to use my name, likeness, image, and voice (collectively referred to as "Likeness") for social media and marketing efforts, including but not limited to, promotional materials, advertising, website content, and social media platforms (e.g., Facebook, Instagram, Twitter, LinkedIn, YouTube) operated by Center Helm LLC. This permission includes the right

to edit, modify, crop, and/or enhance my Likeness as Center Helm LLC deems necessary for such purposes.


I understand and agree that my Likeness may be used in both print and electronic media and may be displayed publicly. I waive any rights of ownership, compensation, or other rights that may arise as a result of the use of my Likeness for the purposes described herein.

PERMISSION TO USE PHOTOS TAKEN BY PARTICIPANT:

I also grant Center Helm LLC permission to use any photographs that I take during the class and surrounding activities, which may include my Likeness and those of other participants, for the same social media and marketing efforts described above.


I understand that Center Helm LLC will make reasonable efforts to credit me as the photographer whenever my photographs are used, but I acknowledge that this may not always be possible or feasible.

RELEASE AND INDEMNIFICATION:

I release and discharge Center Helm LLC and its representatives from any and all claims, liabilities, demands, actions, causes of action, costs, and expenses, whether at law or in equity, whether known or unknown, arising out of or in connection with the use of my Likeness or photographs taken by me, including, but not limited to, any claims for defamation, invasion of privacy, or infringement of publicity rights.


I agree to indemnify and hold Center Helm LLC harmless against any claims made by third parties arising out of or in connection with the use of my Likeness or photographs taken by me.

Date
Month
Day
Year

Medical Release

Date of Birth
Month
Day
Year

Medical Information

Consent to Treatment

I hereby give my consent to receive medical treatment, including emergency first aid, hospitalization, or any other necessary medical care, in the event of an injury or illness during my participation in powerboating activities organized by Center Helm
Yes
No

Health and Fitness Acknowledgment

I confirm that I am in good health and physically fit to handle the rigors of driving and crewing a powerboat, which may include prolonged exposure to the elements, physical exertion, and handling heavy equipment.

Swimmer’s Competency

Acknowledgement of Risk and Release of Liability

I understand that powerboating activities involve inherent risks, including the possibility of physical injury, and I assume all responsibility for any injuries or illnesses that may result from my participation.

Signature

Date
Month
Day
Year

COMPLETE LIABILITY RELEASE

I UNDERSTAND THAT THERE ARE INHERENT RISKS INVOLVED WITH POWERBOATING, including but not limited to equipment failure, perils of the sea, acts of other participants, and adverse sea and weather conditions, and I HEREBY ASSUME SUCH RISKS.


I AFFIRM that I will obey the orders of the Captain appointed over me and the direction charter company.


I UNDERSTAND that harassment (as defined by Safe Sport) of any kind is not only unacceptable, will not

be tolerated, and is grounds for immediate dismissal from the course.


I UNDERSTAND THAT I HAVE A DUTY TO EXERCISE REASONABLE CARE FOR MY OWN SAFETY, AND I AGREE TO DO SO.


I assert that I am physically fit to operate and crew a boat. I will not hold the charter company and/or Center Helm LLC, or their employees, students, or other associated personnel, and their charter responsible if I am hurt or injured as a result of ANY problems (medical, accidental, or otherwise), including COVID-19 which occur while onboard the boat or otherwise participating in the class.


I fully understand that Center Helm and the chartered boat have limited medical facilities. In the event of illness or injury, appropriate care must be summoned by radio or phone, and treatment will be delayed until I can be transported to a proper medical facility. I agree in advance to these conditions.


Center Helm LLC has made no representations to me, implied or otherwise, that they or their crew can orwill perform safe rescues or render first aid. In the event I show signs of distress or call for aid, I would like

assistance and will not hold Center Helm, their staff, or students responsible for their actions in attempting the performance or rescue of first aid.


I understand that my interpretation of the material taught by US Powerboating, Center Helm LLC, and their staff, is exclusively my interpretation. I am fully responsible for the decisions I make and the judgments I use, whether inside the class or aboard any vessel thereafter.


I agree to forever discharge and release, US Sailing, Center Helm LLC, its employees, and agents, the owner(s) of the aforementioned companies and their affiliates, from any and all responsibility or liability for any and all injuries or damages. I agree NOT to make a claim against or sue any of the above parties for injuries or damages whether they arise or result from any NEGLIGENCE or other liability, EVEN IN CASES OF GROSS EGLIGENCE. I further specifically agree, on behalf of myself, my heirs, and assigns, to indemnify and hold harmless the released parties for any and all causes of action arising as a consequence of any incidents which might occur as a consequence of my participation in any boating activities or education with or involving the released parties.

Date of signature (this release is not intended to expire):
Month
Day
Year
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