register - Paddle Battle Long Island

Stand up Paddle Boards G Kayaks
TEA
M
2016
JULY30
L
A
H
C
E
G
N
LE
Peconic River
Riverhead, NY
Racing G Music G Family BBQ Bash
SUP Demos G Raffle Prizes G Vendor Expo
S
Win a 9ft
KAYAK!
$10 Raffle
Registration at 9-10am (Peconic Waterfront)
Team Challenge
Race Course Features:
Win a SUP!
$10 Raffle
2.5 Mile - Fun race for all skill levels!
For more info visit PaddleBattleLIcc.com or call Bryan Deluca at 631.208.9200 x102 or bdeluca@amwny.com.
2016
JULY30
Rain or Shine
(Registration 9:00-10:00am)
In the event of severe weather,
rescheduled Sunday 7/31
T
CHA
EAM
LLE
Peconic River
Riverhead, NY
NGE
Gold Team Challenge Sponsorship - $5,000.00
1. Includes team registration fee for 4 paddlers
6. Four raffle tickets for prizes
2. Logo to appear on: www.PaddleBattlelicc.com landing page top banner, 7. Eight Family BBQ and Bash tickets
Facebook page, our Youtube channel and Causevox page.
8. Booth space the day of event
3. 50% OFF discount coupons to the Long Island Aquarium 9. Four "Team Challenge" tee shirts
(20 Coupons) Valid through 9/1/2016. 4. Rash guard with company logo to be worn by each team member
5. Logo to appear on "Team Challenge" banner
Silver Team Challenge Sponsorship - $2,000.00
1. Includes team registration fee and entry for 4 paddlers
5. Logo to appear on "Team Challenge" banner
2. Logo to appear on www.PaddleBattlelicc.com and Facebook page
6. Four raffle tickets for prizes
3. 50% OFF discount coupons to the Long Island Aquarium
7. Four Family BBQ and Bash tickets
(10 Coupons) Valid through 9/1/2016
8. Booth space the day of event 4. Rash guard with company logo to be worn by team members
Bronze Event Sponsorship - $750.00
1. Booth Space the day of event to sell goods for corporate promotion 2. Logo to appear on www.PaddleBattlelicc.com and Facebook page
3. 50% OFF discount coupons to the Long Island Aquarium
(10 Coupons) Valid through 9/1/2016
Please make check payable to: East End Tourism Alliance
Mail to: 431 East Main St. Riverhead, NY 11901
4. Logo to appear on "Team Challenge" banner
5. Two family BBQ bash tickets
Please visit our website www.PaddleBattlelicc.com for all team and
safety guideline, race day info and frequently asked questions.
All team applications must be submitted by July 21, 2016
COMPANY NAME / ADDRESS:______________________________________
______________________________________________________
TEAM NAME:_______________________________________________
CATEGORY:
RECREATIONAL CLASS KAYAK UP TO 16’ (SIT IN/SIT ON)
STAND UP PADDLE BOARD 12’6” & UNDER
*REQUIRED ONE SUP PER FOUR PERSON TEAM
FIRST NAME:___________________ FIRST NAME:___________________
FIRST NAME:___________________ FIRST NAME:___________________
LAST NAME:____________________ LAST NAME:____________________
LAST NAME:____________________ LAST NAME:____________________
AGE: ________ SHIRT SIZE: ________ AGE: ________ SHIRT SIZE: ________
AGE: ________ SHIRT SIZE: ________ AGE: ________ SHIRT SIZE: ________
PHONE:_______________________PHONE:_______________________
PHONE:_______________________PHONE:_______________________
EMAIL: _______________________EMAIL: _______________________
EMAIL: _______________________EMAIL: _______________________
SIGNATURE: _____________________
SIGNATURE: _____________________
SIGNATURE: _____________________
SIGNATURE: _____________________
EMERGENCY CONTACT: _______________EMERGENCY CONTACT: _______________
EMERGENCY CONTACT: _______________EMERGENCY CONTACT: _______________
PHONE: _______________________PHONE: _______________________
PHONE: _______________________PHONE: _______________________
 ARE YOU A VETERAN?
 ARE YOU A VETERAN?
 ARE YOU A VETERAN?
 ARE YOU A VETERAN?
 SUP OR  KAYAK
 EQUIPMENT NEEDED
 SUP OR  KAYAK
 EQUIPMENT NEEDED
 SUP OR  KAYAK
 EQUIPMENT NEEDED
 SUP OR  KAYAK
 EQUIPMENT NEEDED
Life vests (PFD) are required on craft. All participants must wear PFD (personal floatation device) during race. Must provide your own.
Release: I realize that every time I leave shore in a small boat, I am a potential drowning victim. In addition, there is the possibility of injury from many things, including unseen obstacles,
weather, current, waves, insects and other boaters. Human powered water craft require physical effort which can at times, be heavy, including: lifting, pulling and possibly prolonged
exertion in adverse conditions. In signing this release, I indicate my understanding of the risks involved with activities involving human powered water craft and agree to take full
responsibility for my physical condition, actions and safety.
NOW THEREFORE INTENDING TO BE LEGALLY BOUND, I DO WAIVE FOR myself, my heirs and assigns and for anyone else whomsoever Claiming through me, my right to sue or in any other
way to attempt to hold responsible the United Way of Long Island or the EETA its officers any so-called “race organizers” or “coordinators” or any of my fellow paddlers, for any mishaps
to my person or my equipment, other than that which is due to the willful and malicious action of the individual against whom I claim relief.