OFFICIAL REGISTRATION FORM IMPORTANT: Please make all

Transcription

OFFICIAL REGISTRATION FORM IMPORTANT: Please make all
OFFICIAL REGISTRATION FORM
IMPORTANT: Please make all checks payable to America’s Cardboard Cup Regatta, PO Box 1600, Crystal
Lake, IL 60039-1600.
Name: _______________________________________________________________________
Address: _____________________________________________________________________
City/State/Zip: _________________________________________________________________
Phone: ______________________________________________________________________
Sponsor: _____________________________________________________________________
PLEASE REGISTER MY BOAT AS (Check one):
___
INDIVIDUAL
$20.00 (Includes T-shirt and 1 Free Ticket)
___
HEAT SPONSORSHIP
$125.00 (Includes company name mention on race day, 1 Regatta shirt and 5 free tickets)
___
COMMERCIAL
$200.00 (Includes boat entry with company logo, 1 Regatta shirt and 5 free tickets)
Shirt Size (Important) check one:
___ Small
___ Medium
___ Large
___ X-Large
___ XX-Large
Boat Class
___ Class A (Oar Boat)
___ Class K (Kids 5-10)
___Class B (Other People Power)
___50 Plus
___ Class C (Sail)
RETURN APPLICATION TO:
America’s Cardboard Cup Regatta
PO Box 1600
Crystal Lake, IL 60039-1600
Additional applications available at C.L. Park District and at www.cardboardcup.com.
Cardboard available at Main Beach after May 1, 2015, 9:00am-3:45pm Monday-Friday.
Please have all crew members sign the hold harmless form on the back of this page prior to registering
your boat. Minors must have hold harmless signed by their legal guardian. Additional Waiver and
Release forms can be found at www.cardboardcup.com.
America’s Cardboard Cup Regatta Waiver and Release of All Claims
Please read this form carefully and be aware that by signing up and participating in the America’s
Cardboard Cup Regatta, that you will be waiving and releasing all claims for injuries you might sustain
out of this event.
PLEASE SIGN AND INCLUDE DATES
“As a participant in this event, I recognize and acknowledge that there are certain risks of physical injury
and I agree to assume the full risk of any injuries, including death, damages of loss which I may sustain
as a result of participating in any and all activities connected with or associated with this event.”
“I agree to waive and relinquish all claims I may have as a result of participating in the program against
the Crystal Lake Park District, the Crystal Lake Chamber of Commerce, America’s Cardboard Cup Regatta
Foundation, Inc. and their directors, officers, agents, servants and employees.”
“I do hereby fully release and discharge the Crystal Lake Park District, the Crystal Lake Chamber of
Commerce, America’s Cardboard Cup Regatta Foundation, Inc. and their directors, officers, agents,
servants and employees from any and all claims of injuries, including death, damage or loss which may
have or which may accrue to me on account of my participation in the program.”
“I further agree to indemnify and hold harmless and defend the Crystal Lake Park District, the Crystal
Lake Chamber of Commerce, America’s Cardboard Cup Regatta Foundation, Inc. and their directors,
officers, agents, servants and employees from any and all claims resulting from injuries, including death,
damages and losses sustained by me and arising out of, connected with, or in any way associated with
the activities of the program.”
“Finally, America’s Cardboard Cup Regatta has permission to use my name, comments, photographs,
videos and likeness for any and all archival and promotional purposes directly related to the event and
will not be used for resale. I understand that the circulation of materials could be worldwide and that
there will be no compensation to me for this use.”
I have read and fully understand the above program details and Waiver and Release of All Claims, and
understand that my signature is required below to participate in this event.
____________________________________________________________________________
Signature of Parent, guardian or adult participant
____________________________________________________________________________
Date
____________________________________________________________________________
Participant Name
____________________________________________________________________________
Boat #
____________________________________________________________________________
Boat Name