2023 Dragon Boat: Print Registration Form

Pay-By-Check Registration

Please fill out the form below to register and pay by mail.
Business / Team Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Special Needs
Part 2. Who will be in the boat?

Please include each participants name and email address

If you would like to purchase a t-shirt*, please select your shirt size using the drop down below.

	Name	Email	Shirt Size
Team Captain
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Alternate 1
Alternate 2

* T-SHIRT ORDERS
- Team shirts are available at an additional cost of $20 per shirt (+$2 for XXL.)
- An invoice will be sent to Business or Team Captain at the email address provided above.
- All shirts will be a solid color with white or black print.
- Each team that pre-orders shirts will be assigned a team color.
- Individual shirt orders and shirts purchased at the event will all be the same color.
All participants must sign a waiver and acknowledgment that they have received and read the rules. No team will be permitted to board a boat without signed waivers and payment in full.
Part 3. Select Your Division
Club Division / 20-Person Team: $1,000Community Division / 10-Person Team: $500
Once you have completed this form, please mail your payment to:

Chautauqua Lake Association
429 E. Terrace Ave
Lakewood, NY 14750-1538

c/o Dragon Boat Race
Should be Empty: