National Hospice Regatta Championship
2002
April 12-14, 2002 - Annapolis, Maryland
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
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By entering
and starting in this event, as the Skipper of the
entry, I agree to comply with all conditions
and rules that apply to it.
In consideration
of being permitted to enter this event, being knowledgeable
of the risks of competitive
sailing, and knowing that it is solely my responsibility
to decide whether to start or continue a race, I
voluntarily assume the risk of participation in this
event and release the National Hospice Regatta Alliance,
its Race Committee, and its officers, directors, members,
employees or agents, from all liability in connection
with any injury or damage that may occur.
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.
SIGNATURE _____________________________________________DATE
______________________
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CREW
INFORMATION
List skipper and up to 4 crew, excluding the Owner or
Owner Representative. Additions and substitutions
permitted later by notifying race organizers.
Skipper Name__________________________
Address_______________________________
City, ST Zip ___________________________
email _________________________________
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Crew Name___________________________
Address______________________________
City, ST Zip ___________________________
email ________________________________
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Crew Name___________________________
Address______________________________
City, ST Zip __________________________
email _______________________________
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Crew Name____________________________
Address_______________________________
City, ST Zip ___________________________
email _________________________________
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Crew Name___________________________
Address______________________________
City, ST Zip ___________________________
email ________________________________
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Last Update 12.20.08
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