Electronic Registration Form
*
Name:
*
Street Address:
*
City:
*
State or Province:
*
Country:
*
Home Phone:
*
Email:
*
Verify Email:
*
Age
(as of August 15, 2005)
:
*
Zip Code:
US Sailing Membership#:
Liability Insurance Company:
Insurance Policy Number:
Boat Make & Model:
Spar Manufacturer:
Sail Maker:
Comments and/or Special Instructions:
The items marked with an '
*
' in this upper section are required for Electronic Registration.
The fields in this lower section are optional, now, but will be required to complete your registration. This information can be sent in with your consent form which will be created for you on the next page.
Small
Medium
Large
X-Large
XX-Large
*
T-Shirt Size:
Do you have an official International A-Class Catamaran Measurement Certificate for you boat?
Yes
No
If you answered 'YES' to the question above, please indicate if you have mast(s) or sails(s) that will need measuring.
# of Masts to be measured:
# of Sails to be measured:
US Sailing members receive a $5 discount on their registration.
*
Sail Number:
