Omnium Champlain 2006 :

Online registration form

N.B. Your must fill all boxes marked with an asterisk.

Participant information

First Name:^* Name:^*

Address:^*

City: ^* Province/State: ^*

Postal Code / Zip: ^*

Home phone: ^* Business:

Fax:

Email:

Sailboat information

Boat name: ^*

Builder: ^*

Model: ^* Year: ^* Sail number:

L.O.A.: ^* Draft: ^*Mast lenght: ^*

Type of prop: ^*

PHRF Rating (If you know): Class (If you know):

I would like to enter in the ^*class.

Other information

Winter boat location:

Summer boat location:

Omnium Champlain T-Shirts

Please orderT-Shirts @ $20.00 CAN, $16.00 US each:
A) Total cost of T-Shirts CanadianUS

I understand that T-Shirts are "one size fits all" so I don't have to make any tough size
decisions now and therefore I won't have any trouble with any of my crew and/or family.
T-Shirts can be picked up at the race registration tent on Friday, September 1th..

Registration fees

Received before August 15, 2006: $60.00 CAN / $48.00 US;
August 15 or later: $75.00 CAN / $60.00 US.
B) Registration fee: ^* CanadianUS

Total cost

C) A(T-Shirts) + B(Registration fee): ^* CanadianUS

Please make check payable to Omnium Champlain and mail to:
575 Rivière des Fèves nord, St-Urbain, QC, Canada J0S 1Y0

Important

I hereby release all responsibility of the Omnium Champlain, it's officers and organizers for all damages, physical or material incurred directly or indirectly to the boat, it's equipment or crew. I agree to comply with the international Yacht Racing Rules of my division if contrary to articles 77 & 78 of the IRR. All decision made by the racing committee are final and without appeal. Article 26 concerning publicity and sponsoring is not in effect for this race. I certify that the name, number and registration of the boat are legitimate. The boat will be equipped with all of the security and safety accessories and equipment approved by the United States Coast Guard to sail on the lake. I understand that it is my responsibility to participate, at the time of departure, or to abandon anytime during the race considering the weather conditions.

By clicking on «Send registration» I recognize having read the above rules and responsibilities and I accept to abide by them.