Antique Yachtsman’s Regatta on Keuka Lake

 

Antique Yachtsman’s Regatta on Keuka Lake

Enrollment Form

When: Sunday, June ?, 2020

 Time: 1 PM

 Where: The Glenwood Club

468 East Lake Road

Hammondsport, New York

 Boat Owner’s Name ____________________________________________

 Contact Information

Phone number: ________________________________________________

 Email address: _________________________________________________

 Boat Information:

Builder/Model/Year/Length: ______________________________________

 Number of people participating: __________________________________

 Wine Country Classic Boat Member: Yes/No ________________________

 Payment of $12 per person to cover food/The Glenwood Club and BYOB

No Boat? Thats OK! We would love to have you join us!

 Signed waiver (required) enclosed or presented at time of check in

 

Signed _________________________________________________________

 

 

Date___________________________________________________________

 

 ————————————————————————————————————————————————

 

Wine Country Classic Boats, Inc.,

Antique Yachtsmans Regatta Waiver

 

ANTIQUE YACHTSMANS REGATTA PARTICIPANTS MUST SIGN THIS RELEASE (2 or more
places)

 

2019 Release Form for the Antique Yachtsman’s Regatta. For myself and any members of my family and
guests, including all minors who accompany me or who are otherwise participating in the 2019 Wine
Country Classic Boat cruise at my invitation, I hereby waive any claim for injury to my person, boat, or
personal property for damage which might occur due to my participation either personally or through the
use of my boat, personal property, or equipment in the function known as the “Wine Country Classic Boat
Antique Yachtsman’s Regatta” to be held June 23, 2019, I agree to hold the Antique and Classic Boat
Society, Inc., the Wine Country Classic Boat Chapter of the A.C.B.S., Inc and its members, the Village of
Hammondsport, New York and all other sponsors of this event, their employees, agents and volunteer
assistants harmless for any injury, death or loss suffered by me, my family or my invitee during or in
connection with the Wine Country Classic Boat Show, whether or not such injury, death or loss resulted
directly or indirectly from the negligent acts or omission of said sponsors, employees, volunteer assistants
or others connected with said event(s).

 

SIGNATURE_________________________________________________ DATE  _________________

 

IF DRIVER IS OTHER THAN OWNER please sign below as acceptance of the above release agreement:

 

SIGNATURE __________________________________________________ DATE _________________

 

This statement certifies that I am the owner of the listed boat(s) on the cruise registration form,
and that I certify that I currently have effective insurance to cover any damage to my boat or
equipment, and to cover my liability for any damages to others, or their property arising from any
use of my boat during the Wine Country Chapter of the ACBS Antique Yachtsmans Regatta in
Hammondsport, New York on June 23, 2019. I hold free and harmless the officers and volunteers
of the Wine Country Chapter of ACBS, the Village of Hammondsport, the Town of Urbana, and any
sponsors or advertisers from any and all actions, claims, liabilities, assertion of liability, including
reasonable attorney fees, which in any manner arise or be alleged to arise from any and all
activities connected directly or approximately with the Wine Country Chapter of ACBS boat show. 

I certify that I have the following approved equipment on board: FIRE EXTINGUISHER (S);
PERSONAL FLOTATION DEVICES; ANCHOR; HORN/WHISTLE. I have read the regatta rules
above and agree to be bound by them. I believe the above statement and information to be true.

SIGNED (insured/owner) _________________________  Date __________________________

 

Registrations should be sent no later than June 14 so that meat for the event can be ordered.

Please send registration forms, waivers and checks to:

Randy Fletcher
Attention:  AYR

475 Grosvenor Road
Rochester, New York 14610