DINGHY RACING - 2005

REGISTRATION

This form can either be completed and sent electronically by hitting the "Submit" button, or it can be printed and submitted by mail to:

Dinghy Racing
C/O Bellingham Yacht Club
2625 Harbor Loop Bellingham, WA 98225
Tel: 360-733-7390  

NOTE: BEFORE SUBMITTING THIS FORM WE SUGGEST THAT YOU PRINT A COPY FOR YOUR RECORDS
THIS IS A SECURE SITE. AFTER HITTING SUBMIT BUTTON PLEASE WAIT FOR A FEW SECONDS FOR FEEDBACK INFORMATION
Skipper's First Name * Skipper's Last Name*
Street Address * City *
State * Zip * Email address *
Day phone * Evening phone*

Skipper's Birthdate: MM * DD* YY*

Name of Skipper's Yacht or Sailing Club*:

Sail Number (If you do not know your sail number enter "X"): *
Class:

Laser; Byte; Opti Laser>>; Other


Release I have read the rules and regulations issued for these races and agree to be bound by them. In consideration of acceptance of this entry or my being permitted to take part in thesev races I agree to save harmless and keep indemnified the Bellingham Yacht Club, the organizers and their respective agents, officials, servants, and representatives from and against all claims, actions, costs, expenses, and demands in respect to death, injury, loss, or damage to my person or property, howsoever caused or occassioned by the negligence of the same bodies or any of them, or their agents, officials, servants, or representatives. I further understand and agree that this release is binding upon myself, my heirs, executors, and assigns.

By Checking this box * I accept and agree to the above conditions.
DATE: * INITIALS: *

For Sailors under the age of 18.
Parent or Legal Guardian Acknowledgement. I, the parent or legal guardian of the competitor who has checked the above, hereby certify that I have read and agree to be bound by the terms of this release indemnity on the behalf of the competitor.
By Checking this box * I accept and agree to the above conditions.
DATE: * Full Name: *

Registration Fees:
Series 1 May 31 to June 28 $20:
Series 2 July 5 thru August 2 $20:
Series 3 August 9 thru September 6 $20:
All Three Series $60:

SERIES 4 - September 13 to October 6 - $20:

Total charge on check or credit card * $:

Payment by*: check credit card
If paying with credit card all of the following must be completed
Credit card payment: Visa Master Card
Card number (four numerals per box please):
Expiration date: Month Year
Card holder's name:
Comments (if any)

The above form, if submitted electronically, will be sent to BYC for processing

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Last modified : Thursday, August 18, 2005
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