Dynamic Form - Peninsula Yacht Club

The Safe Harbor Peninsula Yacht Club
Lighted Boat Parade
Boat Registration Form

Member’s only may register to enter their boat in the 2020 parade

Captain's Name:

Name Of Boat:

Address:

Year, Make & Model:

Contact Phone Number:

Length:

Email Address:

Width:

Peninsula Yacht Club Member:

YesNo

Draft:

Member Number:

Category (select applicable):

Sailboat
Houseboat
Under 31' ft
Over 31' ft

Will you be dining at the club?

Time:

# of People:

Vessel Registration Number:

Years of participation in the parade:

Theme of Decorations:

Interesting facts about your boat:

Have Questions? Contact:

Nikole Taylor, Activities Director
18501 Harbor Light Blvd.
Cornelius, NC 28031

Email:
Phone:
Fax:

[email protected]
704-892-9858 x2022
704-892-0961

All registrations must be received by December 11th to be eligible for prizes.

Release, Waiver and Assumption of Risk: I, myself, my heirs, and assigns, release and waive rights against the Peninsula Yacht Club, LLC and Safe Harbor Marinas, their agents, and any other persons assisting in this event for any and all claims directly or indirectly as a participant in the Lighted Boat Parade. I understand that there are inherent risks involved in this event, and agree to hold the aforementioned parties harmless and unaccountable for any such risks. I understand that the Peninsula Yacht Club reserves the right to use any photographs of the event in any promotional materials.

Signature:

Date:

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