2011 Michelob Cup Entry Form

This entry form may change.

If you are interested in entering the Smyrna Yacht Club Michelob Cup Regatta, fill out the application form below. If you do not have all of the necessary information, go ahead and fill in what you have. Be sure to provide the name of your yacht, your name and address, and your phone or email so we may contact you. You may submit another form with the missing information at a later date.

After filling in the form, click the submit button at the bottom of the page.

Application for Entry
Michelob Cup Regatta
October 15 , 2011

Please note that this is a downwind race and it is important to know if you will fly a double headsail or a spinnaker.  If you do not declare the intent, you may not fly the sail.

Name of Yacht	Sail Number
Make/model/designer Year of Manufacture Description/ Type/ Rig	Length Overall Do your have a PHRF Rating Yes No If yes - what is your PHRF Rating

Skipper Information

Name	Telephone
Address	Cell Phone
	Email address
City	State
	ZIP

PHRF Rating Information (** This field not required if a standard production vessel.)

LOA ft.	LWL ft. **	Displacement pounds. **
Propulsion Inboard Outboard Stern Drive None	Prop Folding/Feathering Two Bladed in Aperture Two Bladed not in Aperture Three Bladed Out of water None	Hull form Full Keel Fin Keel Swing Keel Daggar Board Center Board Wing Keel Bulb Keel
I ft. **	J ft.	Water Ballasted yes no
E ft. **	P ft. **
Rated Sail Area sq.ft. **	LP of largest jib ft.	Double Headsail          yes no
Sail foil type Dacron Mylar/Kevlar other - list	if other	Spinnaker yes no

If your vessel is non-standard or there are any other considerations, please lit below. If you have a problem providing the above rating information, a PHRF committee representative will contact you and assist you . Please make sure your contact information is correct and comment below.

WAIVER

In consideration of being permitted to participate in the Michelob Cup Regatta/Rendezvous, and being fully knowledgeable of the risks of sailing as a competitive sport, I agree to release, indemnify and hold harmless the Smyrna Yacht Club, its members, officers and Race Committee, from any and all losses, damages, claims, suits, actions, expenses, or other liability, including, without limitation, attorneys’ fees and expenses, which may directly, or indirectly arise from participation and/or attendance as a spectator or otherwise, by me or any guest or invitee of mine, in the aforementioned Regatta/Rendezvous and any activities related thereto, including, without limitation, any such liability arising, in whole or in part, by reason of the alleged or actual ordinary negligence of the parties released/indemnified above. I recognize that the parties released/indemnified above are materially relying on this agreement by me and that I would not be invited to participate in/attend the Regatta/Rendezvous unless I agree to this RELEASE AND INDEMNITY.

Do you agree with the above waiver ? yes no If the form is submitted on line, please type your full name in the signature block.

Signed Date

If you wish to submit the form by mail, please print the form and mail it to:

David Smith, Chairman
Michelob Cup Regatta
Smyrna Yacht Club
P.O. Box 1560
New Smyrna Beach, FL. 32170

You may pay the entry fee at any time prior to the regatta.
Entry fee: $25.00