New Skipper Application Form "*" indicates required fields Are You Single? (Widowed, Divorced - or in the process, Separated)* Yes No You must be single to apply.Are You a New or Renewing Member?* New Renewing Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Address Consent I give SUS permission for my street address to be posted on the membership list on the Singlesundersail.org website for access only by membersEmail* Birthday (Month/Day)* Home Phone*Cell Phone*Emergency Contact Name* Emergency Contact Phone*How did you learn about Singles Under Sail?*please be specific All Hands-on Deck!*Singles Under Sail, Inc. is run totally by volunteers. Member volunteers are critical to our planning and communicating club activities. Please check at least one area to join the crew: Education Finance Membership Newsletter Programs Public Relations Special/Social Events Web/Information Technology Sailing Availability* Weekday Weeknight Twilight Weekend Days Overnight Sailaways Club Cruises Offshore Are you a Skipper?* No Yes SKIPPERS – Boat DescriptionName Make Homeport Length (LOA feet) Sail No. Hull color Rig type Select one vessel type Sail Power Total Day Sailing Capacity Total Overnight Capacity Skipper's Signature*I understand that it is the responsibility of the Owner/Skipper to provide a safe, insured vessel, which is equipped and operated as required by the U.S. Coast Guard and State agenciesPersonal Skills Assessment SUS Skippers are always looking for crew at all levels. It is important that there is a mutual understanding of each other’s skill level. A Novice - Loves the water but considers himself/herself a beginner and is looking for opportunities to gain practical experience after taking basic sailing/safety courses A Crewmember has sailed before, is familiar with common boat terms and, with proper direction, can perform basic boating tasks. A First Mate has sailed frequently with SUS and/or other boats AND can sail/power a yacht back to the dock if the captain is incapacitated. A Skipper must own, or have access to, a boat meeting USCG standards, capable of taking members on overnight or day sails. He/she keeps the yacht in good and safe condition, can handle the yacht in most conditions encountered in LIS, and knows when to seek safe harbor. An SUS skipper demonstrates good skills and seamanship, and is capable and willing to help their crew improve their skills. I consider myself a competent Long Island Sound:* Novice Crewmember First Mate Skipper I consider myself a competent Offshore: (Non-LIS)* Novice Crewmember First Mate Skipper Do you have a CT/NY Safe Boating Certificate?* Yes No Certificate Number* Date Issued* Certificate UploadPlease upload a copy (file or photo) of your CT/NY Safe Boating Certificate.Max. file size: 10 MB.Do you have a USCG License?* Yes No Type* Date Issued* Emergency Skills (i.e. CPR, First Aid)*Boating, Navigation, Sailing Experience*MEMBERSHIP AND SAILING AGREEMENT Singles Under Sail Inc. stresses safety at sea at every phase of all sailing and water related Activities. In signing this agreement, I fully assume all risks involved, whether on board, swimming, or participating in on-shore activities. I can get on and off a boat from a dock or dingy without assistance. I will not hold SUS, Inc., its officers, or members liable for any injury, illness, or damage I may suffer as result of my participation in any SUS activities. I understand that I am not required to participate in any SUS activity and that my choice is voluntary and without coercion by SUS or any of its members. I understand I am solely responsible for seeking information from Skippers, Crew, or other Members I may require to assure my own safety, comfort and protection. I agree to read and abide by the SUS By-Laws and the SUS Policies, Procedures, Rules and Regulations. I understand that the Skipper decides proper attire and behavior required for the expected sailing conditions. It is my sole responsibility to verify proper attire and behavior by consulting with the Skipper before embarking on any sailing activity. The Skipper may refuse to allow anyone to participate at HIS/HER SOLE DISCRETION. I agree to adhere to all US Coast Guard regulations SUS reserves the right to publish pictures taken at club events in the Masthead and/or on the SUS website. I SHALL PROMPTLY NOTIFY THE SUS MEMBERSHIP DIRECTOR OF ANY CHANGES IN MY PERSONAL INFORMATION OR OF ANY HEALTH /PHYSICAL RESTRICTIONS THAT MAY OR WILL AFFECT MY ABILITY TO PARTICIPATE IN SAILING ACTIVITIES. I understand that this agreement will remain in effect during my membership with SUS, as long as I continue to be a member in good standing. ALL APPLICATIONS ARE SUBJECT TO APPROVALMember's Signature*Date* MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.