The National Hospice Regatta Championship Entry Form
Ft. Lauderdale, Florida
March 23 – 25, 2001

Invited Skippers will receive mailed copies of this form, but may print this page to complete and mail according to the instructions in Notice of Race section 5.0.

SKIPPER NAME _____________________________________________________________

ADDRESS ___________________________________________________________________

CITY __________________________________STATE ____________ZIP CODE __________

DAY PHONE ___________________________ NIGHT PHONE ________________________

FAX ___________________________________EMAIL _______________________________

US SAILING member Yes / No (Circle One) US SAILING NO._________________________
Skippers must be members of their National Authority

By entering and starting this race, as the Skipper of the entry, I agree to comply with all conditions of the race and decisions of the National Hospice Regatta Alliance and its appointed Race Committee, and do for myself, my personal representatives, heirs and assigns, waive any and all claims as they may accrue to them against The National Hospice Regatta Alliance, its appointed Race Committee, the Lauderdale Yacht Club, their officers, directors, members, employees or agents, and any one or more of them arising out of my participation or the participation of my assigned yacht in these races or arising from any activities related to this event. As Skipper, I further acknowledge and agree that neither the National Hospice Regatta Alliance, its appointed Race Committee, the Lauderdale Yacht Club, their officers, directors, members, employees, or agents, assumes or accepts any liability or responsibility for property damage to any boat or personal injury to me, my crew, or friends suffered while participating in these races, including pre-race and post-race activities.

As Skipper, I acknowledge and agree that the decision to start or to continue a race is solely my responsibility.

I hereby give permission for my image, voice, boat, and crew to be photographed and used in promotion of this event and/or other related events.

IYRR 1.4

I understand, in the event of a serious breach of conduct, the destruction of property or the failure to comply with a request of the Race Committee to remove my yacht or crew member(s) from the premises, the Race Committee may reject my entry and hold me financially responsible for any and all damages.

SIGNATURE _____________________________________________DATE ______________________

CREW WEIGHTS

Crew information is required for all yachts. Max crew weight is 440 Kilograms (970 lbs.) excluding the Owner or Owner Representative.


Skipper Name__________________________

Address______________________________

City, ST Zip ___________________________

Weight _______________


Crew Name___________________________

Address______________________________

City, ST Zip ___________________________

Weight _______________


Crew Name__________________________

Address______________________________

City, ST Zip ___________________________

Weight _______________


Crew Name__________________________

Address______________________________

City, ST Zip ___________________________

Weight _______________


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