Entry Form Arizona Yacht Club Tempe Town Lake Match Race Regatta 2004 Tempe Town Lake, Tempe, Arizona May 8, 2004 Mail completed race entry form to the Arizona Yacht Club (AYC) Match Race Committee. All entries must be received by 5 PM, Saturday, May 1, 2004. No entries will be accepted after this date and time. ELIGIBILITY - Eligible skippers are limited to these categories: AYC Members Non-AYC Members registered as skippers for the AYC Fall 2003 or Spring 2004 Tempe Town Lake Race Series Non-AYC Members registered as skippers for the AYC Fall 2003 or Spring 2004 Lake Pleasant Race Series Please PRINT Skipper’s Name ______________________________________ Phone ____________________________ Street Address _________________________________ City _______________ Zip __________________ E-mail Address _________________________________ Registration Class (Circle One) AYC Members Non-AYC Members registered skippers for the AYC Fall 2003 or Spring 2004 Tempe Town Lake Race Series Non-AYC Members registered skippers for the AYC Fall 2003 or Spring 2004 Lake Pleasant Race Series Please enter me in the AYC Tempe Town Lake Match Race Regatta, May 8, 2004 at Tempe Town Lake, Arizona. I agree to be governed by the current Racing Rules of Sailing (RRS), the prescriptions of US SAILING and the instructions contained in the Notice of Race. I also agree to the following: 1. I hereby release the Arizona Yacht Club, any sponsoring group, its officers, agents, or committee people from any and all liability for any injury of myself or damage to my boat arising out of conduct of the race, to the extent that such release does not discharge my insurance policies. 2. I further agree to indemnify the Arizona Yacht Club and the owner of any borrowed boat assigned to me for these races for any loss or damage that may occur to the boat assigned to me and to any other property damaged by the assigned boat while it is in my use/possession, whether being unloaded, rigged, launched, sailed, docked, de- rigged, retrieved or returned from assignment back to the Race Committee. 3 I also agree to hold Arizona Yacht Club and the owner of any boat assigned to me blameless and save them from any expense or claim that might arise from any injury or damage to persons or property that might occur while the assigned boat is in my use of possession. I agree to pay all attorney's fees, court costs or other reasonable expenses incurred if legal action becomes necessary to defend any legal proceeding seeking to retrieve compensation for property damaged or persons injured by the assigned boat in my use or possession. Signed _____________________________________________ Date ____________________________ Make check payable to: ARIZONA YACHT CLUB Entry Fee: AYC Members $20.00 Mail to: Emory Heisler Non-Members $25.00 TTL Match Race Committee PO Box 598 Tempe, AZ 85281 Phone: (602)679-0462 Email: emory.heisler @ cox.net Check #________ VISA, M/C, A/E #______________________________ Expiration __/____/___ Amount $_________ US SAILING members may deduct 10%. Proof of membership must be provided upon request.