Know All Men By These Presents:

THAT I, __________________________________ , am the parent or guardian of _______________________________________,
                       (parent's name - printed)                                                                              (child’s name - printed)
who has made application for a Junior Membership in the HAMPTON YACHT CLUB, INCORPORATED.

IN CONSIDERATION of the acceptance of ___________________________________ as a Junior Member in the Hampton Yacht
                                                                               (child’s name)
Club, Incorporated, I hereby release and forever discharge the Hampton Yacht Club, Incorporated, its officers, members, guests,
employees, successors and assigns from all manner of action, causes of actions, claims, demands for damages, (including
personal injury or death), in law, or equity, by reason of _________________________________________ being a Junior Member
                                                                                                    (child’s name)
of the said Hampton Yacht Club, Incorporated, or entering into any activity of the Club or using the Yacht Club property or other
property connected with the Hampton Yacht Club, Incorporated while a Junior Member of the same; and I do further agree to
indemnify and save harmless the said Hampton Yacht Club, Incorporated, from any claims, loss or damages sustained by it as a
result of the aforesaid activities of my child or ward. Further, I agree to indemnify and save harmless the said Hampton Yacht
Club, Incorporated for any expenses including costs and reasonable attorney fees arising out of any loss or claim for damages
sustained or caused by said Junior Member. I acknowledge that sailing in the activities of the Junior Program are inherently
dangerous and I assume the risk of any injury or loss incurred in such activities.

THIS RELEASE AND INDEMNITY AGREEMENT shall continue in force from year to year so long as my said child or ward shall
be a Junior Member in the said Hampton Yacht Club, Incorporated.

As used herein the term Hampton Yacht Club, Incorporated includes the Officers Directors, Members, Instructors and Employees
of the Hampton Yacht Club, Incorporated.

IN WITNESS WHEREOF I have hereto set my hand and seal this day of                                       , 2008.

______________________________________________________________ Parent or Guardian

  MEDICAL RELEASE

Authorization for Emergency Medical Treatment:

Let it be known that I,_________________________________, am legal resident of ______________________________________
now residing at_________________________________________________ am the lawful parent/guardian and have full custody of
 _______________________________________________.

That I have made, constituted, and appointed, and by these presents do make, constitute and appoint personnel of the Hampton
Yacht Club Junior Sailing Program or Hampton Yacht Club to act for me and in my name place, and stead to perform any and all
acts hereinafter set down, as fully to all intents and purposes as I might or could if personally present, with full power of
substitution and revocation, hereby ratifying and confirming all the sail personnel shall do or cause to be done by virtue of this
power, to wit:

AUTHORIZE ANY AND ALL MEDICAL AND HOSPITAL CARE AND TREATMENT, INCLUDING MAJOR SURGERY, DEEMED
NECESSARY BY A DULY LICENSED PHYSICIAN OR DULY LICENSED STAFF PHYSICIAN AT ANY MEDICAL FACILITY
WHICH IS NECESSARY FOR THE HEALTH AND WELL-BEING OF MY CHILD NAMED HEREIN.

The terms of this appointment becomes null and void after October 15, 2008.

In witness whereof, I have heron set my hand and seal this (day) ____ of (month)______________ , 2008 .

 __________________________________                      __________________________________
                 (signature of Parent/Guardian)                                                                  (signature of Parent/Guardian)

Child's Medical Information or History (such as allergies, medications, etc.___________________________________________
 ________________________________________________________________________________________________________

Child's medical doctor:___________________________ Doctors address____________________________________________
Doctors phone number: _________________________

IN CASE YOU CANNOT BE REACHED, PLEASE PROVIDE A BACK-UP NAME AND PHONE NUMBER TO BE USED IN CASE
OF AN EMERGENCY: 

NAME_________________________________________ PHONE NUMBER___________________

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