2020 Antique Yachtsman’s Regatta on Keuka Lake
Enrollment Form
When: Saturday, June 13, 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 meat/The Glenwood Club and BYOB
Everyone will bring a dish to pass. When I know who will be attending, I will email out a form for dishes you intend to bring, so we won’t have too many of one dish.
No Boat? That’s OK! We would love to have you join us!
Signed waiver (required) enclosed or presented at time of check in
Signed _________________________________________________________
Date___________________________________________________________
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Wine Country Classic Boats, Inc.,
Antique Yachtsman’s Regatta Waiver
ANTIQUE YACHTSMAN’S REGATTA PARTICIPANTS MUST SIGN THIS RELEASE (2 or more
places)
2020 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 13, 2020, 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 Yachtsman’s Regatta in
Hammondsport, New York on June 13, 2020. 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 1 so that meat for the event can be ordered.
Please send registration forms, waivers and checks to:
Patti Bandy
2405 Country Estates Road
Penn Yan, New York 14527