ENTRY FORM 2012

9th Annual Marco Island RC/Laser Mid-Winter Championship Regatta  March 2,3,4 2012

 Hosted by Marco Island Model Yacht Club and the City of Marco Island Parks & Recreation Department

Skipper Information (Please Type or Print)

NAME: ________________________________________ Fleet Affiliation:  _______________________

ADDRESS: ___________________________________________________________________________

CITY: __________________________________ STATE: __________________ ZIP: _________________

PHONE #: (day) _____________________________ (evenings) ________________________________

E-MAIL: __________________________________________ Fax: _______________________________

______

Boat Information:

Sail # __________ Hull Color _________ Frequency / Transmitter Type _______________

Note: All participants must be a current member of the RC Laser NA Association www.rclaserna.com

  Annual dues are $10; Log on to site, go to Member Sign Up; follow directions. Dues are renewed annually on your anniversary date.

I hereby accept to participate in the City of Marco Island Parks & Recreation Laser Regatta. I am aware that participating in this

 event can involve risk or injury, including serious injury. I fully understand that the City of Marco Island, its agent, officers,

 and employees accept no responsibility and will not be liable for any injury, harm or damage to his/her person or property

 occurring during or arising out of participation in said event. In consideration of accepting this entry, I hereby for myself,

 my heirs, executors, and administrators waive and release any and all right to claim damages that I or my family may

 have or acquire against Marco Island Model Yacht Club, their membership, the sailing site, owner, employees, agents,

 representatives or assigns, the AMYA and RCLNA, or its members for any and all injuries suffered by me and my family

 during the regatta and related events. I have read the Notice of Race for the 2011 RC Laser 8th Annual Midwinter Regatta

 at Frank E. Mackle Park and accept its conditions and rules.

Signature of Competitor: ________________________________________ must be signed

Date: ____________________

Registration Fee: $100  before February 18, 2012; $120 thereafter.

Includes: sailing packet, box lunch Saturday and Sunday; Friday night cocktail party with heavy Hors d’oeuvres and

 “Go Fast” clinic; Saturday night buffet dinner at the Marco Island Yacht Club (cashBar) – dinner includes one

free well drink and hors d’oeuvres. (Dinner attire is casual but please no jeans or t-shirts).

Skipper ___$100 Guests: Extra box lunches @ $8 /day _________ Extra dinners @ $45 _________

TOTAL ENCLOSED _________

Make checks payable to Marco Island Model Yacht Club (MIMYC) and send to:  Rocky Cale,

108 Beachcomber Street, Marco Island, FL. 34145 Sailing or housing questions:

 George sjprmi@yahoo.com  or Rocky rockycale@hotmail.com/  239-642-1825)