Canada Day MICA Island Race July 1, 2024 Registration

Please make sure you subit the registration form before paying the entry fee…thanks!

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Name *

First

Last

Boat Name *

PHRF Handicap *

Insurance *

• Yes
• No

Email *

Address

Cell Phone number

Class entered *

• PHRF Handicap Band 150 and lower Class A
• PHRF Handicap Band 151-270 Class B
• PHRF Handicap Band 270 and over Class C

Method of Payment *

• Paypal / Credit Card
• Cash
• Cheque

Consent *

• I accept the the following statement: As an entrant to the Canada Day MICA Island Race , July 1, 2023, I agree to save harmless and keep indemnified the Indian Point Yacht Club, The Lunenburg Yacht Club, and the Mahone Islands Conservation Association. their organizers, officers and their representatives, from and against all claims, actions, costs, expenses and demands in respect to death, injury, loss or damage to my person (or family members) or property, however caused, arising out of or in connection with my (or my family members) taking part in The Canada Day MICA Islands Race 2024

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