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 vaccinatedCompleted 1 of 2 shotsNot vaccinated
Will you have completed your second vaccination by May 28?

YesNo
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?*

YesNo
I am age 18 or older:*

YesNo
Name of Parent/Guardian:*
Parent/Guardian Phone Number*

Area CodePhone Number
Should be Empty: