2017 Keelboat Racing Registration Form Bellingham Yacht Club Skipper Name* First Last Address* 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 Day or Cell Phone*Email* Enter Email Confirm Email Fleet and Boat InformationFleet Type*PHRFOne-Design ClassRecreational (Cruising)PHRF Rating*Yacht Type*Boat NameSail Number*Length Overall*Hull ColorYacht ClubUS Sailing #Crew Member(s)Crew NameEmail AddressPhone Number Race and Minimum Equipment Requirements DUE TO LIABILITY ISSUES, FAILURE TO MEET THESE REQUIREMENTS WILL RESULT IN DENIAL TO RACE! You MUST supply copies of your CURRENT PHRF and INSURANCE certificates! mail to: Sail Fleet Captain, BYC, 2625 N. Harbor Loop Dr., Bellingham WA 98225 or drop off in the downstairs mailbox. All vessels must complete, sign, and have on board a copy of the PIYA "Minimum Equipment" form If you are competing as a cruising boat with a PHRF, and require handicap adjustment, please contact Neil Bennett for the required form. If you are not a member of PHRF or need a PHRF Certificate, contact PHRF here . Racing WaiverIn consideration for participating in BYC Races, 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.Waiver Acceptance* I accept the above statement. Date* Name* First Last Racing SeriesSelect the series in which you wish to participate. Complete Series* All Wednesday Night and Weekend Series ($75) All 2017 Wednesday Night and Weekend Series Selected Price: $75.00 Total $0.00 Payment Option*Please select payment option. Do not send cash by mail! BYC Members may charge their racing fees to their account.Credit Card (via PayPal)Charge to Account (BYC Members)Check This iframe contains the logic required to handle Ajax powered Gravity Forms.