This Section Is To Be Completed And Handed In At The Registration.

Friday October 22, 2004

Name of Boat____________________________ Length____________

Captain’s Name_____________________________________________

Home Port_________________________________________________

Telephone #___________________ FAX #_______________________

Do You Need Diesel/Gas? Y / N (Circle). Quantity_________________ GAL/LITRES

As a condition of entry into the Nevis Yacht Club Sports Fishing Tournament, I accept that the club, and its organizers will not be responsible for the loss of life or injury to any participant in or during the event, nor will the club be responsible for the loss or damage to any vessel howsoever caused before during or after the event. I also agree not to hold the Nevis Yacht Club or any of its members responsible for personal injury, loss, or legal actions.

I understand the rules of the competition and I certify that I will follow these rules.

Captain’s Signature_____________________________________________

Please print below:

1.____________________________(Captain)

Anglers

2.____________________________ (Female)

3.____________________________ (Junior)

4.____________________________

5.____________________________

6.____________________________

7.____________________________