ALLISON JOLLY REGATTA
Florida State Girls Championship
Opti, C420, Laser Radial & Laser 4.7
St. Petersburg Yacht Club
St. Petersburg, Florida
April 14 & 15, 2012
Entry Form:
Optimist Sail#______Fleet: Blue _____ Red_____ White_____ Green_____
Club 420 Sail#______Laser Radial #______Laser 4.7 #______
Name______DOB______
Club ______
Parent or Guardian______
Address______
Phone______e-mail______Adult Contact # During Event______
Name (420 Crew)______DOB ______
Parent or Guardian______
Address______
Phone______e-mail______
Fee for entries postmarked on or before April 6, 2012 for the Optimist, Laser Radial & Laser 4.7 fleet is: $50.00 per boat; thereafter entry fee shall be $60.00. Fee for entries postmarked on or before April 6, 2012 for the Club 420 fleet is $75.00 per boat; thereafter entry fee shall be $90.00. Deadline for entries is 1700, Thursday, April 12, 2012. If your entry will be late please contact the regatta chair directly at or 727-421-6467.
Checks should be made payable to Salty Sisters. Mail to: St Petersburg Yacht Club Salty Sisters, c/o Susan Wallace, Regatta Chair, 11 Central Ave., St. Petersburg, FL 33701
WAIVER
As a condition of my child’s entry in the 2012 Allison Jolly Regatta and Florida State Girls Championship, and being fully knowledgeable of the risks of sailing as a competitive sport, I waive any and all claims, charges, losses and liabilities including those caused by negligence, against the Florida Sailing Association and the St. Petersburg Yacht Club, their respective officers, trustees, contractors, employees and members, and against any and all volunteers which may arise from, or in any way be in connection with, the activities of the regatta and its organizers. I further agree that my child will be bound by the Racing Rules of Sailing and by all other rules which govern this event.
Competitor (Print name)______
Competitor signature______
Crew (print name)______
Crew signature______
Parent/Guardian signature______Date______
Parent/Guardian (Print name)______
THIS REGISTRATION IS NOT COMPLETE WITHOUT AN EXECUTED MEDICAL CONSENT FORM INCLUDING A CONTACT # FOR THE RESPONSIBLE ADULT DURING THE EVENT