The Regatta Network website uses cookies to give you the best experience possible.Find out more

Register For
2017 Laser Gulf Coast Championships
Corpus Christi Yacht Club

June 9 - 11, 2017
 
View this form in:
Event Fees

Registration Fee:
 
$90.00
 

Skipper Information

Items marked with a * are required unless stated otherwise.

Have you registered with US SAILING Regatta Network before? Enter your name and US SAILING Number, then click the 'Look Up My Information' button below to retrieve your information tied to your US SAILING number.
Skipper First Name*:
Skipper Last Name*:
US SAILING # (USA ONLY):
  Look Up My Information
Are you a member of the International Laser Class Association
Int. Laser Class #*:
  Look Up My Number
ZIP/Postal Code*:
Address*:
City*:
State/Province*:
Country*:
Phone Number*:
Cell Phone Number:
  Allow text messages from event organizer
Email Address*:
Email Address Confirm*:
Yacht Club Affiliation*:
Birthdate*:
Parent/Guardian Name*:
Parent/Guardian Cell Phone*:
Parent/Guardian Email*:
   
   
Emergency Contact Name*:
Emergency Contact Relationship*:
Emergency Contact Phone*:
   
List Any Medical Conditions*:
List Any Medications Taken*:
List Any Allergies or
Special Dietary Requirements*:
Boat Information
   
Sail Number* :
Desired Class :
   

In the event of accident, injury or illness involving me, or if applicable, a child of mine named above as the "Competitor," while in, on, or about the premises of a Corpus Christi Yacht Club (“CCYC”) or while participating in any regatta or activity sponsored by or under the auspices of CCYC under circumstances where I am physically unable to consent or am not present,
1. I hereby voluntarily authorize and consent to the furnishing to myself, or any child of mine, of such medical care, attention, and treatment by any hospital, physician or dentist as such hospital, physician or dentist may deem necessary or advisable, including any x-ray examination, anesthetic, medical, or surgical diagnosis or procedure.
2. I authorize any adult associated with the activity to consent to such medical care, attention and treatment.
3. I agree to pay the reasonable cost of such medical care, attention or treatment and to indemnify and hold free and harmless of and from any and all liability for such cost the assisting adult, CCYC, and its officers, employees and members of said CCYC.
It is understood that effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached.

LIABILITY RELEASE AGREEMENT
IN CONSIDERATION OF ACCEPTANCE OF MY REGISTRATION TO PARTICIPATE IN THE REGATTA AND, RECOGNIZING THE RISKS ASSOCIATED WITH THE SPORT OF SAILING, THE UNDERSIGNED HEREBY WAIVES ALL CLAIMS FOR PERSONAL INJURY AND PROPERTY DAMAGE AND HEREBY RELEASES THE CORPUS CHRISTI YACHT CLUB, AND ITS DIRECTORS, OFFICERS, MEMBERS, EMPLOYEES, AND THE REGATTA OFFICERS, VOLUNTEERS AND SPONSORS, OF AND FROM ANY AND ALL CLAIMS, INCLUDING THOSE OF NEGLIGENCE AND GROSS NEGLIGENCE, WHICH I OR MY CHILD MIGHT HAVE, ARISING OUT OF MY AND/OR MY CHILD’S PARTICIPATION IN THE REGATTA AND ALL ACTIVITIES RELATING THERETO.

I agree to the above:
 

 
Registration Problems or Questions? Visit our Support Desk | View Our Privacy Policy
Powered by US SAILING Regatta Network® | Online Sailing Event Registration and Management Services.
© 2017 Regatta Network, Inc. All Rights Reserved. Regatta Network is a registered Trademark of Regatta Network Inc.
Powered by Regatta Network