BACK TO SCHOOL REGATTA
LAKE
HOPATCONG YACHT CLUB
Early
Registration to Donna Norman 509
Benson Place, Landing, NJ 07850
Name
____________________________________________________________
Address
__________________________________________________________
Age as of
9-15-12 __________Yacht Club Affiliation _______________________
Sail #
____________________
Fleet
(circle one) RED BLUE
WHITE GREEN 420 (limited to 20
registrants)
Make checks
payable to LHYC (please note BTSR on memo line)
Registration
Fee: $50.00
_______________________
Non-Participating Pizza Lunch (___x$8.00) __________________________
Total ________________________
Liability
Waiver
No sailor may sail without a completed and
signed waiver: Waiver of Liability. In
consideration of the U.S.O.D.A. and the Event Hosts allowing the undersigned
participant to participate in the above named event, I recognize and understand
that the Regatta is voluntary in nature and participation is at the invitation
of the Event Hosts and organizers. I
recognize that my child incurs risks attendant with sail, water related
activities and other event activities. I hereby absolve the Lake Hopatcong
Yacht Club, the sponsors of this Regatta, the organizers of this event and the
members of the Race Committee from all responsibility or liability for loss of
life or injury to participants or others, or for the loss of or damage to any
vessel, equipment or other property.
This document may have serious consequences in the event of any injury
to the participant. I HAVE READ AND
UNDERSTAND THE FOREGOING RELEASE.
Participant’s Name
_______________________________________________________
Parent or Guardian’s Signature _______________________________Date ___________