Event/Participant Registration
Register for the Negril Emancipendence Celebration Regatta. Please complete all required fields. Registration Fee Individual $J500 Team J$2000
Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Emergency Contact Name
*
Emergency Contact Relationship to Participant
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Swimming Categories
Under 20 Open Water
Over 20 Open Water
Boating / Kayak Categories
1k Kayak Sprint
40 CC Boat Race
60 CC Boat Race
Team/Boat Name
Vessel Type
Own
Rental
Vessel Make/Model
Do you have any medical conditions, allergies, or injuries we should be aware of?
*
Yes
No
If yes, please specify
Swimming Ability
*
Beginner
Intermediate
Advanced / Competitor
Payment Method
*
Cash on Arrival
Bank Transfer
Participant Signature
*
Signature Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Signature (If participant is under 18)
Register
Register
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