2017 Canadian 2.4mR Class Registration

2017
Class Registration Form
Canadian 2.4mR Class Association
Please complete each of the following sections by clicking on the heading.

1. Contact Information
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Home Phone *

Area Code Phone Number
Work Phone

Area Code Phone Number
Mobile Phone

Area Code Phone Number

2. Boat Information
Hull Number
Sail Number
Boat Name
Boat Builder
Date of last buoyancy test

Month Day Year
Certified by

First Name Last Name
Buoyancy Certificates are valid for 5 years from the date of the buoyancy test. Please see the web site for more details.
Club Affiliation
Non Boat Owner

NBO

3. Before you click Submit
Complete all sections before you click Submit
REMEMBER: A red star means you MUST complete the field with valid information.
You will be redirected to the payment processing page after you submit this form.
Should be Empty:

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