Regatta:              

Registrant Name:

Address:            

Phone Number:      Alternate Phone: 

E-Mail Address:  

Date of Birth:        (mm/dd/yyyy)

T-Shirt Size:        Shirt_Size Small Medium Large X-Large XX-Large

Yacht Club     GYA Club Number:

                                                                              (required if charging registration to GYA Club account)

Sail Number:  (Sail # required)

Registration:           $50.00 (includes registration, continental breakfast Saturday and Sunday, dinner Saturday night and one (1) t-shirt)

Payment Method:  Choose Payment Method Charge to my GYA Club Acct Charge to my CC Will pay at registration

If Applicable:

Credit Card:         Credit Card AmEx MasterCard Visa Discover

Name as it Appears on CC:

Card Number:                     

Exp. Date:  Month 01 02 03 04 05 06 07 12 08 09 10 11    Year 2010 2011 2012 2013 2014 2015    

Additional comments:

ON-LINE REGISTRATION IS NOT COMPLETE UNTIL PAYMENT IS RECEIVED BY FYC.  REGISTRANTS SHOULD CHECK-IN AT REGISTRATION DESK PRIOR TO COMPETITORS' MEETING