ENTRY FORM
20 _____ NSA MIDGET REGIONAL and CHAMPIONSHIP
BYO -Optimist Events
Complete in full. Incomplete entry form will not be accepted. At the completion of the regional event, send one copy to the hosting championship contact. After the NSA championship, please send copies as directed by information packet sent from the NSA office.
NSA Sailing Club or Affiliation of the participant: ___________________________
The following must be completed by an Officer of the participant's yacht club or sailing association:
I certify the participant is a member of the _________________________________
Date _________________ By _______________________________
Signature of Officer
_____________________________ ________________________
Office held Please print name
Competitor _________________________________________ M / F
Birthday ____/ ____/ _______
______________________ _____________________ _______________
Street City State and zip code
Email ________________________________ Phone #________________
US Sailing # __________________________ Weight __________________
I agree that to follow the event sailing instructions and the current Racing Rules of Sailing.
Signature ____________________________ Date________________
Signature of competitor
