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Registration

JSA of LIS Roster

New Registration change

You are about to sign up for a new registration. If you would like to renew an existing registration with JSA of LIS please tap 'change' above.

Jr. Sailor Personal Details

first name

last name

Nickname/Preferred Name (optional)

Sailor email address

*If sailor does not have an email address, please enter primary parent email.

Sailor mobile number

*If sailor does not have a mobile number, please enter primary parent mobile number.

Weight

Sex

Medical conditions, allergies, etc.

*Please enter "none" if nothing significant for emergencies.

School Name - Upcoming Fall

Club & Boat Details

sail number

*Please enter "TBD" if sail number is unknown.

Summer Program Club

boat name (optional)

Roster details may be shared with the program director at your selected club, and the event hosts of any JSA regattas for which your sailor is registered.

Parent/Guardian (completing this form)

We'll send all online waiver requests to the Parent/Guardian email address you provide above. Additionally, the parent above will be listed as the primary emergency contact for JSA regattas.

Secondary Parent/Guardian

Additional Emergency Contacts

Emergency Contact 1

Mobile Number

Email Address

Relationship to Jr. Sailor

Emergency Contact 2

Mobile Number

Email Address

Relationship to Jr. Sailor

Medical & Insurance Information

Physician Name

Physician Phone Number

Insurance Provider

Name of Primary Insurance Holder

Insurance Policy Number

Insurance Group Number

Home Address of Jr Sailor

Street Address

City

State

Postal Code

Select a Registration Plan

Fees

Select Plan

payment

Grand Total

Select Plan

Credit/Debit Card

You will be prompted to enter card details on the next step.

Remember me for faster payment next time.

waivers

We will send a link for you to complete the JSA waiver electronically. Please make sure that your Parent/Guardian email address is correct.

Register with JSA

I agree to Regatta Toolbox terms and conditions.