Skipper Name :

Email :

Address :

City :

State :

Zip :

Phone :

Sail # :

Club :

Check all that apply :

Release of Liablity :

In consideration of this Entry acceptance, I agree that the safety of my boat and the decision whether or not to start or continue a race is my responsibility. I hereby waive all claims which I may have against the Atlanta Yacht Club (AYC), its officers, members, committees or agents arising out of or in anyway connected with my participation in any race or related activity sponsored by any of them. I agree to be bound by the RRS and by all other rules that govern this event.

Make check payable to : Laser Fleet 116

(Note ... after clicking on "Submit", you will be taken to a "Thank You for contacting us" page. We don't anticipate any difficulties, but just in case ... if you are not automatically taken to the "Thank You" page, please email your registration info directly to Mike Carlson)