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FLORIDA POWERBOAT CLUB
WINTER POKER RUN TO KEY LARGO 2018
January 26-28
Member Name: ______
Boat Name-Make: ______ New boat? Y / N
Email: ______ Zip code: ______
Cell Phone: ______Decal Color choice: ______
Names of Crew: Please indicate t-shirt sizes. Crew names are very important (video, etc…)
Captain: ______1st Mate: ______
T-shirt size: S M L XL XX (circle one) T-shirt size: S M L XL XX (Ladies top)
Crew 1: ______Crew 2: ______
T-shirt size: S M L XL XX (Ladies top) T-shirt size: S M L XL XX (Ladies top)
Crew 3: ______Crew 4: ______
T-shirt size: S M L XL XX (Ladies top) T-shirt size: S M L XL XX (Ladies Top)
Crew 5: ______Crew 6: ______
T-shirt size: S M L XL XX (Ladies top) T-shirt size: S M L XL XX (Ladies top)
______
Event fees DO NOT INCLUDE accommodations or dockage.
*Note: Late fees of $100 will be added for registrations received after January 5, 2018
Event Fee: (Captain & mate): $800………………………….………………………………………...$______
Extra crew: ______X $175.00Includes event tee andfunctions passes….…….$______
Additional T-shirts or Ladies tanks $20 each.……..………………………………….…………..$______
Tee Sizes: ___S ___M ___ L ___XL ___XX - Ladies tanks: ___S ___M ___L
Safety Management Fund: $50 for all boats……...... $50.00
Other Charges/credits: ………………………………………………………………………………….…...$ ______
Total Payable:………………………….…………$______
FEES PAYABLE TO: FLORIDA POWERBOAT CLUB: 1214 SW 6th St. Pompano Beach, FL 33069
Event Fees may be paid by: (Please Check One)
AmexM/CVISADiscoverCheck
Card#:______Exp:______CVV: ______
Name: ______Signature: ______Date: ______
No returns or refunds on cancellations. Credit policy applies to all prepaid event fees
PLEASE FAX FORM TO(954) 782-2452 or email
CONTACT FLORIDA POWERBOAT CLUB FOR MORE INFORMATION: Weekdays 10AM – 5PM
(954) 545-1414 - Fax (954) 782-2452 -
FLORIDA POWERBOAT CLUB – WINTER POKER RUN 2018 Page 2 of 2
Docking and Accommodations - Reservation Form
Member Name:______Date:______
_Note: A copy of your insurance declaration page must accompany this registration.
Club Membershipis necessary to participate on this event. Do you need membership information? Y / N
DEPARTURE HOTEL & MARINA IN SUNNY ISLES
Thursday Jan 25(Limited Rooms – Please contact FPC for these SPECIAL RATES)
Doubletree by Hilton OceanPoint Resort & Spa: Number of rooms: ______
Room type: One bedroom suites and standard studio: $299 ______King ______Double
Two bedroom suites: $449 ______King ______Double
Special Needs:: ______Return Rooms: Y / N
Docking Info: Haulover Marine Center Slip: Y / N Water: Y / N Electric: Y / N
.
PLAYA LARGO RESORT & SPA Number of rooms: ______
Two story Bungalow $639 ______1 king upstairs with sleeper couch and 1 king
Downstairs (can sleep 6) (3 LEFT)
Single/Double Bay Front Suite $519 _____ King _____ Double (SOLD OUT)
Partial Bay View $439 _____ King _____ Double (3 LEFT)
Resort View $ 359 _____ King _____ Double (1 LEFT)
(Check Out is Sunday January 28)
Docking Info - $3.00/ft Slip: Y / N (Limited to 25 Boats in Total Registration)
Credit Card Info - AmexM/CVISADiscoverCheck
Card#: ______Exp: ______Vin: ______
No returns or refunds, cancellations.edlicy applies to all prepaid event fee
PLEASE FAX FORM TO(954) 782-2452 or email