Send this page and check to VYBA, INC.  1330 Tarpon Center Drive, Venice, Fl. 34285

Registration Fee per sailor is $20 postmarked before March 15 ______

Late Registration Fee is $30 per sailor                                       ______

         Registration includes lunch

Lunch (Parents/Friends) $5 each             # _______                   _______

TOTAL                                                                                       _______

 (Note:  There is no place to buy lunch at this site)

 Please do not mail forms and checks later than March 15, but bring to registration.

REGISTRATION

NAME____________________________________Date  of Birth________Age___   M ___  F___

ADDRESS______________________________________________PHONE_________________

TEAM / CLUB            ___________________________________  CLASS  ________________

 SAIL # ________________T-SHIRT SIZE (CIRCLE) : ADULT  S, M, L, XL  CHILD S, M, L,

WAIVER OF LIABILITY

By allowing my child ___________________________to participate in the regatta, I recognize and understand that participation in the races is voluntary in nature and is at the invitation of the Venice Youth Boating Association, Inc.  I recognize that my child incurs risks attendant to sail and water related activities.

I___________________________fully agree to waive any and all claims, charges, losses, and  liabilities including those caused by negligence against Venice Youth Boating Association, Inc., its officers, directors,  and members; Sarasota County Parks and Recreation Department and against any and all volunteers, parents, participants or others who may in any way be connected with the practices or  activities of the races.

I understand that I am responsible for the actions of my child while he or she may be participating in the Races and on the grounds of Indian Mound Park of Sarasota, County.

Parent's name (Signature)__________________________Date_________

(Print Name)  _________________________________________________

Child's Name (signature)  _______________________________Date __________

(Print Name)  _________________________________________________