Regatta Financial Form

National Hospice Regatta Alliance

P.O. Box 1054 McLean, VA 22101 forms@hospiceregattas.org
APPLICATION for REGATTA MEMBERSHIP

Thank you for your interest in starting a Hospice Regatta! Please complete this form, submit it and someone on our Board of Directors will be in touch to discuss next steps.
Today's Date

MonthDayYear
i. Proposed Regatta Name *
"Hospice Regatta" in name helps publicize the purpose. Name may identify location, body of water, or other unique characteristics. See examples on Alliance Web site.
YN
ii. Regatta Month, Date, Year

MonthDayYear
Date
iii. Regatta Location, city state, plus body of water
Hosting Club, Organization
iv. Person(s) Applying

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
v. Primary Contact for NHRA (if different than above)

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
vi. Benefiting Tax-exempt Hospice
Please be prepared to share verification of tax exempt status under Section 501(c)(3) of the IRS Tax Code, and that the hospice is non-profit and provides services without regard to patients' ability to pay.
vii. Race Management
What organization or group recognized locally as competent and committed will conduct the regatta in accordance with the rules of US Sailing?
We'd love to hear about your ideas for this regatta.
Please verify that you are human*
Should be Empty:

National Hospice Regatta Alliance