2011Club420RegistrationForm

2011 Club 420 Association North American Championship

Registration Form

* Required

Title

First Name *

Last Name *

Email Address *

Date of Birth *

Home Address *

City *

State *

Zipcode/Postcode *

Country *

Home Phone Number *

Cell Phone Number *

Sail Number *

Hull Number *

C420 Membership Number *

Visa/Mastercard Payment with expiry date: *

First & Last name of Crew Member *

Address of Crew Member *

Email address of Crew Member *

Home phone number of Crew Member *

Date of Birth of Crew Member *

RELEASE:
For and in consideration of the acceptance by the Buffalo Canoe Club of my entry in the 2011 Club 420 Association North American Championships, I hereby accept all the risks and responsibilities of my boat's participatio in said regatta and waive to the fullest extent permitted by law any and all claims I may have against the Buffalo Canoe Club, its members, officers, committees, volunteers, agents and/or employees arising out of or in any way connected to such participation. I agree to be bound by the 2009-2012 Racing Rules of Sailing and by all other rules that govern this event. I further expressly agree that the foregoing release and waiver is intended to be as broad and inclusive as is permitted by law and that if any portion, clause or subclause hereof is held invalid, it is agreed that the balance shall, nothwithstanding, continue in full force and effect.

It shall be the responsibility of each skipper to decide whether or not to start or continue to race.

I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and waiver of claims and sign it of my own free will. Any participant under the age of 18 must have a parent/guardian sign this form.

I agree to the terms below. *
Yes I agree
No I do not agree (your form will not be accepted)

Title
First Name *
Last Name *
Email Address *
Date of Birth *
Home Address *
City *
State *
Zipcode/Postcode *
Country *
Home Phone Number *
Cell Phone Number *
Sail Number *
Hull Number *
C420 Membership Number *
Visa/Mastercard Payment with expiry date: *
First & Last name of Crew Member *
Address of Crew Member *
Email address of Crew Member *
Home phone number of Crew Member *
Date of Birth of Crew Member *
RELEASE: For and in consideration of the acceptance by the Buffalo Canoe Club of my entry in the 2011 Club 420 Association North American Championships, I hereby accept all the risks and responsibilities of my boat's participatio in said regatta and waive to the fullest extent permitted by law any and all claims I may have against the Buffalo Canoe Club, its members, officers, committees, volunteers, agents and/or employees arising out of or in any way connected to such participation. I agree to be bound by the 2009-2012 Racing Rules of Sailing and by all other rules that govern this event. I further expressly agree that the foregoing release and waiver is intended to be as broad and inclusive as is permitted by law and that if any portion, clause or subclause hereof is held invalid, it is agreed that the balance shall, nothwithstanding, continue in full force and effect. It shall be the responsibility of each skipper to decide whether or not to start or continue to race. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and waiver of claims and sign it of my own free will. Any participant under the age of 18 must have a parent/guardian sign this form.
I agree to the terms below. * Yes I agree No I do not agree (your form will not be accepted)