The Villages R/C Model Boat Club
Registration Form
2014 US12 National Regatta
The Villages (Lady Lake), Florida
April 2, 3 2016
Check-In April 2, 8:00 AM
Skipper's Meeting, 9:15 AM
Racing from 9:30 AM to 3:00 PM
Please make check out in the amount of $35.00 (+ $5.00 for guests) to:
"The Villages R/C Model Boat Club"
Send completed form with check to:
Brian Engle, 17250 SE 94th Coults Cir, The Villages, Fl 32162
Questions? E-mail :[email protected]
Receipt deadline is March 29, 2016
Name: __________________________________________________
AMYA #: _____________________
Address: _______________________________________________
City: __________________ State: _______ Zip: _____________
Phone #: _______________ E-mail: ________________________
Number attending Saturday Dinner: _______
Sail #: _______________
Freq: 1) _______ 2) ________ 3) ________4) ________(must have three frequencies)
Or Spectrumor other 2.4GHz: _________
In consideration of accepting this entry, I hereby for myself, my heirs, executors and administrators, waive and release any/all
rights to claim damages that I may have acquired against the sponsor club, or its members, The Villages of Lake-Sumter, Inc., the sailing site owners, employees, agents, representatives, or assigns and the American Model Yachting Association, or its members, from any claim for injury or other damages to me or my family during this regatta's events:
Signature: _________________________________ Date: _________________
Registration Form
2014 US12 National Regatta
The Villages (Lady Lake), Florida
April 2, 3 2016
Check-In April 2, 8:00 AM
Skipper's Meeting, 9:15 AM
Racing from 9:30 AM to 3:00 PM
Please make check out in the amount of $35.00 (+ $5.00 for guests) to:
"The Villages R/C Model Boat Club"
Send completed form with check to:
Brian Engle, 17250 SE 94th Coults Cir, The Villages, Fl 32162
Questions? E-mail :[email protected]
Receipt deadline is March 29, 2016
Name: __________________________________________________
AMYA #: _____________________
Address: _______________________________________________
City: __________________ State: _______ Zip: _____________
Phone #: _______________ E-mail: ________________________
Number attending Saturday Dinner: _______
Sail #: _______________
Freq: 1) _______ 2) ________ 3) ________4) ________(must have three frequencies)
Or Spectrumor other 2.4GHz: _________
In consideration of accepting this entry, I hereby for myself, my heirs, executors and administrators, waive and release any/all
rights to claim damages that I may have acquired against the sponsor club, or its members, The Villages of Lake-Sumter, Inc., the sailing site owners, employees, agents, representatives, or assigns and the American Model Yachting Association, or its members, from any claim for injury or other damages to me or my family during this regatta's events:
Signature: _________________________________ Date: _________________