2017 KarMART PITCH Regatta Registration September 2 - 3, 2017 Contact InformationSkipper/Owner* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Enter Email Confirm Email Yacht InformationYacht NameSail Number*If unknown, enter "X". Must be supplied to the RC prior to the regatta.PHRFIf registering for PHRF class, a copy of your current PHRF Certificate is REQUIRED prior to receipt of your race packet at check-in.Yacht TypeLength OverallHull ColorYacht ClubCrew InformationCrewClick the plus icon (+) to add more crew.NamePhoneEmail Event WaiverEvent Waiver In consideration for participating in this event, I represent to its organizers that my yacht has liability insurance currently in effect, covering property damage, personal injury and death in an amount not less that $300,000 per occurrence, and that the policy covers yacht racing activities. I acknowledge that the decision to enter my yacht and crew to participate in this event is solely my own; and I agree to be bound by the International Yacht Racing Rules as adopted by US Sailing, including national prescriptions, except as modified by the organizers, and the race notice for this event. I further agree to hold harmless the Bellingham Yacht Club, its officers, representatives or race committee for damages or losses which I or anyone on my boat may incur which are associated with my participation in this event and related activities. By completing this section I accept the above statement: Full Name*Date* Registration InformationEarly Registration (received by 21 August 2017):$85 USD Registration (received by 28 August 2017): $115 USD Late Registration (received after 30 August 2017): $130 USD Early Registration*Registration (by 8/21/17) - $85Early Registration Extended InformationExtended Early Registration (received by 30 August 2017):$85 USD Late Registration (received after 30 August 2017): $130 USD Early Registration Extended to 8/30/2017 - $85*Early Registration (Thru 8/31/2016) - $85Late Registration*Registration (after 8/31/16) - $130Saturday Night DinnerTri-Tip DinnerTri-Tip Steak, Baked Potato, Caesar Salad, Rolls Price: $10.00 Quantity: Registration TotalTotal $0.00 Payment MethodSelect Payment Method** Checks must be received by discount date to receive the discount. Credit Card Online via PayPalCharge to Account (BYC Members Only)Mail Check* If mailing a check or credit card information, make check payable to "BYC" and send payment with copy of registration to: PITCH Registration Bellingham Yacht Club 2625 South Harbor Loop Dr. Bellingham, WA 98225 Mailed checks must be received no later than Friday, September 1, 2017! This iframe contains the logic required to handle AJAX powered Gravity Forms.