Regatta Registration Form                No. _________                                              November 5 - 7 , 2010 
 
Name:       (Print) _________________________________________________________
Number in Party: _________________________________________________________
Home Phone Number: _________________________________________________________
Cellphone Number: _________________________________________________________
Email Address: _________________________________________________________

Condo: Room #________________
Regatta Events:                        I Plan To Participate In The Following Events
Boat Inspection -- Coast Guard _________  
Boat Decorating Contest _________  
Kayak Race _________    Kayak Provided
Sailboat Race _________    Your Boat _____ or as Crew _____
Regatta Expense:
Regatta Registration Fee $50.00 / person X         #________ Total $____________
                                        Check # __________________

Checks Due by October 15, 2010 Payable to "PGI Seafarers"
Check the online web list to confirm that your reservation has been received.
You must pick up coded wrist band at registration -- no one will be admitted without!

Mail Registration Form & Check To:
Linda Supakoff
PMB 138
1133 Bal Harbor Blvd., Suite 1139
Punta Gorda, FL  33950

No cancellations / refunds after October 20, 2010

Click on these links for separate forms for Dock Reservations and T-Shirts