Regatta 2008 Registration Form
I/We hereby register for and state our intentions to participate in the Lackawanna River Regatta 2008. I/We agree to hold the Lackawanna River Corridor Association harmless from any liabilities which may arise from the ridiculous, sublimely absurd or sardonically evocative nature of our Regatta entry, its methods of navigation, communication, decoration or our techniques in the use of duct tape; whether or not we use duct tape or admit that we use duct tape. I/We also acknowledge that we are aware of Pennsylvania Fish & Boat Commission regulations requiring all small craft crew and passengers to have a Personal Floatation Device and a whistle or horn at hand.
Please
Print Clearly
Captain ____________________________Address ____________________________ ____________________________ |
Phone _____________________________ e-mail _____________________________ |
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First Mate_________________________ Address ____________________________ ____________________________ |
Phone _____________________________ e-mail _____________________________ |
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Yeoman____________________________ Address ____________________________ ____________________________ |
Phone _____________________________ e-mail _____________________________ |
Bosun_____________________________Address ____________________________ ____________________________ |
Phone _____________________________ e-mail _____________________________ |
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Seaman____________________________ Address ____________________________ ____________________________ |
Phone _____________________________ e-mail _____________________________
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Theme
of Vessel (optional):_______________________
Name of Family or Sponsor Group:_________________________________________
Name
of Business Sponsor:_______________________________________________