www.islandtoislandwatermanrelay.com Island to Island Waterman Relay Race Entry Form 1, 2014 October 1

www.islandtoislandwatermanrelay.com
Island to Island Waterman Relay Race Entry Form
October 11, 2014
Santa Barbara Island to Isthmus, Catalina Island
Please Circle Your Team Class:
SUP 14’ – Stock Paddleboard – Unlimited Paddleboard
TEAM NAME: _________________________________
OC 1’s – Surf Ski
Escort Vessel Name (Captains admission fee is included): ____________________________________________
Teams of 3: (Please print legibly)
Name
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Address
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City
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State & Zip
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Country
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Phone
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Age
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Email
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Please Circle Size:
Complimentary T-Shirt:
L
XL
XXL
Additional T-Shirts available $15
L
XL
XXL
$300 Entry Fee Includes (After September 15, the entry fee will be $325):
• 3:30pm Show • 5:45pm Dinner & Raffle • 6:45pm Awards Presentation • 8:00pm Finish
Additional dinner tickets may be purchased at event, $65 per adult & $25 per child 12 and under.
Liability Waiver. You must read and sign to participate :
(Entrants must be 18 years of age or older):
In consideration of my entry in the Island to Island Waterman Relay Race held on October 11, 2014, I for myself, my heirs, executors,
administrators, and assigns, waive and release any and all rights and claims for negligence I may have or accrue against the County of Ventura,
County of Los Angeles, the City of Los Angles, Catalina Island, Santa Barbara Island, Lifeguard Services, Giles D. Finlayson, and any other race
sponsors or co-sponsors or their representatives, agents, successors, and assigns for any and all damages or injuries or death which may be
suffered as a result of my participation in this event. I attest and verify that I am physically fit and sufficiently trained for the competition of
this race. I am completely and solely responsible for my own safety. I understand that the race will be covered using general photographic,
film, and/or digital video cameras and may be televised. By signing this entry, I release all rights or propriety claims for the use of my image or
voice to be photographed, videotaped or filmed for commercial or any other purposes. I authorize the unconditional use of my image or voice
in any form while participating in this event. I confirm that I am 18 years of age of older .
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Participant Signature
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Date
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Participant Signature
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Date
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Participant Signature
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Date
Please mail completed entry form and check to (make checks payable to Island to Island Waterman Relay):
Island to Island Waterman Relay Race - c/o Giles Finlayson • 1810 Parliament, Encinitas, CA. 92024 760.436.5928
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