Black Fly Scullers
1382 Fellows Road
Danville, Vermont 05828
Phone : (802) 745-7207
Fax : (802)748-4323
info@blackflyscullers.org
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The Thirteenth Inaugural Black Fly Regatta will be held on Saturday June 21, 2014
at approximately 9:01:52AM EDST. Membership dues are: $40 per sculler


First Name:
Last Name:
Gender: Male Female
Age:
Address 1:
City / State-Province-Country / Zip:
Phone Number:
Email:
Please enter me in the following Swarm:
BLACK FLY REGATTA T-SHIRT ORDER FORM
Wanna buy a groovy t-shirt? You bethca! T-shirts cost $20 a piece ( they come in one piece ). Orders received by June 11 will be at the venue. Orders received after that date will be mailed to you approximately two-three weeks later.
Size: S M L XL
Quantity:
Total Due ( $40 plus $20 per t-shirt - you do the math):
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
I have read the above Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement in its entirety and fully understand its terms. I understand that I have given up substantial rights by typing my initials below, and that I initial freely and without any inducement or assurance of any nature. I intend my initals to indicate a complete and unconditional release of the Black Fly Scullers and its affiliates of all liability to the greatest extent allowed by law and agree that if any portion of the Release and Waiver of Liability.
Assumption of Risk and Indemnity Agreement is held to be invalid, the balance, notwithstanding, shall continue in full force. I also fully understand that if I participate outside of my Swarm I will be deemed by the Constitutional Monarch to have broken the Black Fly Regatta Golden Rule - no porta potty for me. The only thing I'll find poached at the Black Fly Regatta are Pete & Gerry's eggs. Taper Hard!
Initial here:   and   
Members under the age of 18, please print the Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement above, have your parents sign and date it, and bring it with you to the regatta. We cannot allow you to race if you do not have your Release properly signed and on your person the day of the regatta - no excuses.
Black Fly Scullers * 1382 Fellows Road * Danville, Vermont 05828
* Phone:(802) 745-7207 * Fax:(802)748-4323
 
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