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Entry Form
National Hospice Regatta Championship 2003
April 11-13, 2003 - Annapolis, Maryland
SKIPPER NAME ________________________________
REPRESENTING________________________________HOSPICE REGATTA
ADDRESS______________________________________________________________________________
CITY_______________________________________________ STATE_________
ZIP_________________
DAY PHONE______________________HOME PHONE______________________________
CELL PHONE_____________________FAX______________________________________
E-mail________________________________
US SAILING MEMBER Yes / No (Circle
One) US SAILING NO.__________________________________
Skippers must be members of their National Authority
OUR TEAM WILL BE STAYING AT
__________________________________
PHONE #____________________________________
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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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MAIL THIS ENTRY
FORM TO:
Linda Ambrose, Event Coordinator
1106 Van Buren Street
Annapolis MD 21403
Contact: Linda Ambrose - lbba@mindspring.com
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