National Powerboat Association - Glen Cove Poker Run Entry Form

		Glen Cove Powerboat Poker Run 2009 Entry Form Fill out this form and print and send it with check N.P.B.A., 30 Morgan Ave., Greenwich,CT 06831 Tel/Fax: (203) 532-1312

Name

Address:

Phone:

Day:

Eve:

Fax:

E-mail:

Age:

(You must be 18 years old . . plus)

Where did you hear about this event

Make of Boat

L.O.A.

YR.

Name of Boat:

Color

Registration No.

No. of Engines:

Hull Made of:

Home Port:

Engine Make:

Horsepower:

Cubic Inches:

Outdrive:

Exhaust System

Ratio:

Props:

Cruising Speed

Top Speed

Size & Pitch

Event:

$300.00 Includes 2 entry hands and dockage

$100.00 per extra hand

# in Crew:

Total $ Enclosed:

Insurance Co.

Policy #

Signature:_________________________________________________________ Date:_______________________

Make checks payable to: The National Powerboat Association, 30 Morgan Avenue, Greenwich, CT 06831-4940

PAYMENT IS REQUIRED IN FULL FOR REGISTRATION ACCEPTANCE

THERE ARE NO REFUNDS ONCE YOU HAVE ENTERED.

1.Each Riding member in the event must be a member of the National Powerboat Association which costs $20.00.

The Membership Form is on the website: <Click here for Membership Form>

2. Each Riding member in the event must wear a life jacket...preferably one that won't fly off if you hit the water.

3. Entry Fee : $300.00

4. There are 2 Parties, 1 Friday night, 1 Saturday Afternoon.

5. The Boat must be insured, Policy number required on entry form.

You will receive confirmation and event instructions after receipt of entry form and payment.

For more event information call:
The National Powerboat Association at 203-532-1312

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