167th Annual Regatta COVID-19 Vaccination Attestation Form

NYYC COVID-19 Vaccination Attestation Form
READ BEFORE SIGNING

The following attestations are being asked to establish your COVID-19 status as it relates to attending a 167th Annual Regatta Dinner. All guests must be fully vaccinated to attend.
Have you been fully vaccinated? *

Yes, fully vaccinated Completed 1 of 2 shots Not vaccinated
Will you have completed your second vaccination by May 28?

Yes No
I hereby agree to abide by the rules, regulations, and policies of the Organizing Authority and the State of Rhode Island regarding all COVID ‐19 related safety measures.

I knowingly, willingly, and voluntarily acknowledge the inherent risks associated with a communicable disease such as COVID-19 at any event sponsored shore-side activity and that that my admittance thereto requires that I have been fully vaccinated.
First Name: *
Last Name: *
Boat Name: *
Sail Number:
E-mail: *
Cell phone: *
Numbers only, No dashes. Start with area code
Are you an NYYC member? *

Yes No
I am age 18 or older: *

Yes No
Name of Parent/Guardian: *
Parent/Guardian Phone Number *

Area Code Phone Number
Should be Empty: