2.4mR Regatta Registration Form

Regatta
First Name	MI. Last Name
Address	apt.
City	St. Zip Country
Phone	Fax
Email	Sail #
Style of Boat	Does the boat you are going to sail have a float test certificate? yes no Does the boat you are going to sail have a valid measurement certificate? yes no
US SAILING Member or National Authority# Is this a Team Qualifier for you?
Insurance Company	Policy #
To the fullest extent permitted by law, I hereby waive any rights I may have to sue the race organizers (organizing authority, race committee, protest committee, host club, sponsors, or any other organization or official) involved with the event with respect to personal injury or property damage suffered by myself or my crew as a result of our participation in this event and hereby release the race organizers from any liability for such injury or damage.
Signature Datemm/dd/yyyy
When you click "OK" below, you will be directed to make your payment online, however, if you prefer to mail your payment, you do not have to complete the credit card portion of this process but please press the "OK" button to enter your information into our database. You may print this page for your records. Please see Notice of Race for your Regatta to get mailing instructions. Thank You.