2004 Perry Series #4
Newport Harbor Yacht Club
March 13-14, 2004
ENTRY FORM

Entrant Information Sail#:
Skipper: Crew:
Mailing Address:
Phone # Email:
Yacht Club:

Event Information

Complementary Continental Breakfast will be served each morning at 9 am.

Bag Lunches (water, sandwich, fruit, chips, and dessert) will be available at a cost of $6.00 each (payable to NHYC) and must be PRE-ORDERED by March 10, 2004.

Amount Due

Lunches (must be pre-ordered)

$6.00 each--lunch orders are payable to NHYC

Saturday

Turkey ______

Roast Beef______

Sunday

Turkey ______

Ham ______

Total # ordered

_______x $6.00

$
NHYC accepts checks (payable to NHYC), and member charge

Total

$
NHYC member charge NHYC #

Please send a complete form and lunch orders (payable to NHYC)
by March 10, 2004 to:
c/o Perry Series
Newport Harbor Yacht Club
720 West Bay Ave
Balboa, CA 92661

I agree to comply with all rules and regulations of Newport Harbor Yacht Club, US SAILING, USCG, and other rules under which this race or series is sailed. I hereby release Newport Harbor Yacht Club, its Officers, Directors and Committeemen from any and all liability for any jury to myself, my crew, or damage to my yacht arising out of their conduct of these races, or the use of NHYC facilities, to the extent that such release does not discharge my insurance carrier under the provisions of the insurance policies on my yacht. I assume any risk of injury or damage arising out of my participation in the regatta, failures or breakage of my yacht, or any of its equipment, or weather conditions.

I certify that all members of my crew, including myself, are able to swim. If my yacht is moored/stored at NHYC before, during and/or after the series, I understand that NHYC may move the yacht, or adjust and/or modify the mooring, and the club is hereby released from, and shall incur no liability as a result of such action. I further agree not to sail in hazardous conflict with commercial shipping.

Signature________________________________________________ Date______________________________

Parent/Guardian Signature (if under 18)_______________________________________________________Date________________________