Carbotec Masters Regatta Registration Form

Carbotec Masters Regatta Registration Form

Please fill out the following information to register for the event.
Skipper Full Name

First NameLast Name
Boat Details:
Email Address
example@example.com
Contact Phone Number
Please enter a valid phone number (numbers only).
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number (Numbers Only).
My Products
prevnext( X )
Event Entry per Boat
$100.00NZD

Tee ShirtEvent T-Shirt
$45.00NZD QuantitySize

Total

$0.00NZD
Payment:

Bank: Bank of New Zealand

Account Name: TAIKATA SAILING CLUB INCORPORATED

Account Number: 02-0152-0042250-000

Particulars: CMR Code: [Your sail Number] Reference: [Your surname]
Agree to Terms and Conditions*

I agree to comply with the rules and regulations of the event.I understand that participation in on water activities involves risks and I release the event organisers from any liability.I grant permission to the event organizers to use any photographs or videos taken during the event for promotional purposes.
Should be Empty:

Payment: