OFFICAL ENTRY FORM
2000 MISSOURI GOVERNOR'S CUP - Oct 13 thru Oct 15
Lake Stockton Yacht Club
Mail, with postmark by September 24, to: Carol Miller, POB 593, Blue Springs Mo 64013
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| Skipper Name & Address: |
____________________________________________
____________________________________________
____________________________________________ |
| Telephone: |
____________________________________________ |
| Yacht Club Affiliation: |
____________________________________________ |
| Yacht Name: |
____________________________________________ |
| Make/Size: |
____________________________________________ |
| Sail Number: |
____________________________________________ |
| Hull Color: |
____________________________________________ |
| Race Fleet: |
( ) PHRF Spinnaker ( ) PHRF No Spinnaker |
| Crew: |
____________________________________________
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Registration: Please fill in each blank, including reservations for Friday night (free to racers & crew but we need a number), the total for each item, the total amount of your enclosed check, and finally, sign below. |
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# Reservations |
$ Enclosed |
$ Late Registration |
|
|
|
(no exceptions) |
| LSYC member Race entry fee … $45 |
_____ |
$ __________ |
$65.00 |
| Non member Race entry fee … $55 |
_____ |
$ __________ |
$65.00 |
| Saturday dinner … $15 ea |
_____ |
$ __________ |
$17.50 |
| Friday … please enter a # |
_____ |
$ n/c |
$5.00 |
| T-Shirts … enter # for sizes |
| Short sleeve $10 ea ___M ___L ___XL |
| Long sleeve $15 ea ___M ___L ___XL |
|
$ __________ |
|
Total Enclosed |
$ __________ |
(payable to LSYC) |
|
I, the undersigned, in charge of the aforementioned yacht, understand that my right to participate in this yachting event is conditioned on my agreement to comply with the following requirements:
- The undersigned has the sole and exclusive control and management of the yacht or vessel described herein,
- That the undersigned and not Lake Stockton Yacht Club (LSYC) shall be wholly and fully responsible for the control, care, and safety of such yacht and crew,
- That the undersigned shall indemnify and hold harmless the LSYC, its officers, directors, committees, and members for any damage, loss, or injury, whatever its cause or extent, to myself, crew or property arising out of my or our participation in this yachting activity,
- That the undersigned shall comply fully with the racing instructions and safety requirements set forth by the race committee and those required by all jurisdictions, local, state, and federal,
- That the undersigned has in force and effect a policy of liability insurance which covers the owner, skipper, crew, and vessel while engaged in this yachting activity.
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| Owner or Skipper's Signature:_________________________________ Date: ____________ |