New England 100 Registration Form

August 6th-7th 2005

Please fill out this form online so we can get an idea of who is planning on attending this event.

User Information

Skipper First Name: 

Last Name:

Street Address: 

City: 

State: 

Zip Code: 

Telephone: 

FAX:

 E-Mail: 

US Sailing #:

Crew First Name: 

Last Name:

Street Address: 

City: 

State: 

Zip Code: 

Telephone: 

FAX: 

E-mail:

Roadcrew First Name:

Last Name:

Street Address: 

City: 

State: 

Zip Code: 

Telephone: 

FAX: 

E-mail:

Boat Information

Boat type :

Sail number: 

Spinnaker?

Additional Mods?:

I May need the following:

 Crew

 Road Crew

I want to crew for someone else

 Dinner Tickets?

Comments / Suggestions