2016 WOW Regatta Registration Form Saturday, July 9, 2016 All required information is marked with a red asterisk. This registration form can be used for skippers registering a boat or for crew looking for a boat. All boats are required to register, but only crew needing a boat need to register. There is no charge to register for this event, but donations are appreciated. Participant InformationName* First Last Participant Type*Skipper Registering a BoatCrew Member Looking for a BoatAddress* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Enter Email Confirm Email Yacht Club MembershipBoat InformationBoat Name*Sail Number*If not known, type an X in this field. Sail number will be required for scoring the race.Yacht Type*PHRF Rating*Division*RacingCruisingWould you be willing to take on crew needing a boat?*YesNoEvent WaiverEvent Waiver In consideration for participating in this event, I represent to its organizers that my yacht has liability insurance currently in effect, covering property damage, personal injury and death in an amount not less that $300,000 per occurrence, and that the policy covers yacht racing activities. I acknowledge that the decision to enter my yacht and crew to participate in this event is solely my own; and I agree to be bound by the International Yacht Racing Rules as adopted by US Sailing, including national prescriptions, except as modified by the organizers, and the race notice for this event. I further agree to hold harmless the Bellingham Yacht Club, its officers, representatives or race committee for damages or losses which I or anyone on my boat may incur which are associated with my participation in this event and related activities. By completing this section I accept the above statement: Waiver Terms Agreement*By entering your full name, you hereby acknowledge that you have read and agree to the terms of the Leukemia Cup Regatta Waiver.Waiver Signature Date Event DonationWould you like to make a donation to WOW to help fund the regatta?*YesNoDonation Amount Enter a donation of any amount. Thank you for supporting the cause.Total $0.00 PaymentPayment Type*Credit Card via PayPal (PayPal membership not required)Charge to My Account (BYC Members Only)Check (Payable to BYC)Cash (Payable at the BYC Bar)We accept credit cards which are processed through PayPal. A PayPal membership is not required to use this feature.If paying by check submit payment to: WOW Regatta Bellingham Yacht Club 2625 South Harbor Loop Drive Bellingham, WA 98229 Contact: Cathy Holland - Regatta Coordinator This iframe contains the logic required to handle Ajax powered Gravity Forms.